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Clinical outcomes, quality of life, advantages and disadvantages of metal stent placement in the upper gastrointestinal tract

Vlavianos, Panagiotisa,b; Zabron, Abigailc

Current Opinion in Supportive and Palliative Care: March 2012 - Volume 6 - Issue 1 - p 27–32
doi: 10.1097/SPC.0b013e32834f6004
GASTROINTESTINAL SYMPTOMS: Edited by Dorothy M.K. Keefe and Jervoise Andreyev
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Purpose of review This review will discuss the immediate- and long-term success, complications and overall benefits of self-expandable metal stents (SEMSs) in malignant or benign obstruction of the oesophagus, stomach and duodenum. Over recent years, indications such as benign disease have expanded, as has SEMS diversity with self-expandable plastic stents (SEPSs) or fully covered and biodegradable stents, for example.

Recent findings SEMSs have been increasingly used in malignant upper gastrointestinal obstruction with many reports confirming efficacy, despite a significant complication rate. Fully covered stents are increasingly used for a variety of benign oesophageal disease, but their place in gastric outlet obstruction is still unclear. Covered and uncovered stents have different functional characteristics and stent type must be selected on an individual basis. Biodegradable stents show promise and the outcome of experience in larger patient cohorts is eagerly awaited.

Summary This area is an evolving field, in which the clinician requires up-to-date knowledge of therapeutic options to make individualized treatment choices in difficult clinical circumstances. Technical and clinical success for oesophageal or gastroduodenal SEMSs are then above 90%. Minor complications are common, but serious complications seldom occur. Biodegradable stents may be useful, especially when stenting is needed for a short period of time.

aImperial College Healthcare Trust

bHammersmith Hospital

cHepatology and Gastroenterology Section, Division of Diabetes Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, UK

Correspondence to Panagiotis Vlavianos, Imperial College Healthcare Trust, London W12 0HS, UK. Tel: +44 208 3838562; e-mail: Panagiotis.vlavianos@imperial.nhs.uk

© 2012 Lippincott Williams & Wilkins, Inc.