Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis

Jung Hoon Park, Ho Young Song, Sung Cheol Yun, Moon Won Yoo, Min Hee Ryu, Jin Hyoung Kim, Do Hoon Kim, Jeong Hoon Lee, Wei Zhong Zhou, Jeong Hwan Yook, Hwoon Yong Jung

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objectives: To compare the outcomes between stent placement and surgical gastrojejunostomy (GJ) for the palliation of gastric outlet obstruction (GOO) in patients with unresectable gastric cancer. Methods: A retrospective study was performed in a single university hospital in 224 patients with GOO, and who were treated either by stent placement (n = 124) or surgical GJ (n = 100). The outcomes were assessed with reference to the following variables with the use of propensity-score matching: success rates; complications; dysphagia scores, albumin, and body mass index; survival; symptom-free duration; and hospitalization. Results: We identified a well-balanced cohort of 74 pairs of patients, matched on the basis of propensity score. The dysphagia score 7 days after treatment was significantly better in the stent group (P < 0.001). Albumin level 1 month after treatment was significantly lower in the stent group (P < 0.001). Symptom-free duration and hospitalization were significantly longer in the surgery group (P = 0.002, P < 0.001, respectively). The recurrence rate was significantly higher in the stent group (P = 0.032). Conclusions: Stent placement can provide faster symptom relief and shorter hospitalization, while surgical GJ can provide longer symptom-free duration, less recurrent obstruction symptoms and better nutritional status. Key Points: • The two methods are equally effective in palliating gastric outlet obstruction symptoms • The stent group showed rapid and efficient palliation of symptoms • Recurrent symptoms were more frequent in the stent group • Surgical gastrojejunostomy provides a longer symptom-free duration and better nutritional status

Original languageEnglish (US)
Pages (from-to)2436-2445
Number of pages10
JournalEuropean Radiology
Volume26
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Keywords

  • Dysphagia
  • Gastric bypass
  • Gastric outlet obstruction
  • Stents
  • Stomach neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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