Traitement des stenoses gastriques ou duodenales malignes par pose de protheses metalliques sous controle fluoroscopique

Purpose. - To evaluate the efficacy of metallic stents for palliation of malignant gastro-duodenal stenosis. Materials and methods. - Twenty-three patients aged from 36 to 88 years old presented with nausea, vomiting and weight loss due to duodenal (n = 16) or antro-pyloric (n = 7) malignant stenosis and underwent placement of 37 Wallstents (1 to 3 per patient) under fluoroscopic guidance. Results. -After initial stent placement 17 patients had normal food intake. One patient was able to eat fractionated meals. Five patients did not experience any improvement due to the presence of a jejunal stenosis downstream in 2, or insufficient stenosis coverage in 2 and stent migration in 1. Nine of the 18 patients with improvement died without symptoms within 101 ± 56 days after stent placement and 6 were alive and symptom-free after a mean follow up of 176 ± 83 days. Three asymptomatic patients were lost to follow up after 3 days, 1 and 2 months, respectively. Conclusions. - Metallic stents appear to be a valuable option for the treatment of malignant gastro-duodenal stenoses.