Covered Stent Placement in Patients with Recurrent Cancer after a Billroth I Reconstruction

Purpose: To assess the technical feasibility and clinical effectiveness of covered stent placement in patients with recurrent malignant obstructions after Billroth I reconstruction. Materials and Methods: From June 1997 to November 2005, 16 patients underwent covered stent placement for recurrent gastric cancer after Billroth I reconstruction. A total of 19 covered stents were used, including 14 dual stents and five fully covered stents, as available. Results: Stent placement was technically successful in all patients, with 13 of 16 patients (81%) showing improvement of symptoms. Stent migration occurred in one patient, tumor ingrowth in one, and stent collapse and/or bowel perforation in one. Nine patients (56%) had concomitant (n = 7) or subsequent (n = 2) biliary obstruction. One patient was lost to follow-up. The remaining 15 patients died 5-628 days (median, 52 days; mean, 120 days) after stent placement due to progression of disease or pneumonia. Conclusions: Placement of covered metallic stents is feasible and effective in patients with recurrent malignant obstruction after Billroth I reconstruction.