Duodenal Stent
Duonenal Stent

Video Endoscopic Sequence 1 of 18.

Duodenal Neoplasia

This is a 72 year-old female, who was referred to our endoscopy unit due to bleeding from the upper gastrointestinal tract, manifested with hematemesis and melena and signs of bowel obstruction, endoscopy find an extensive neoplasia between the second, third and fourth portion of the duodenum, magnetic resonance determined that there are other masses in the abdomen and pelvis.

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Duonenal Stent

Video Endoscopic Sequence 2 of 18.

Another image and video clip of endoscopy with extensive tumor of the duodenum between the second, third and fourth portions.

Duonenal Stent

Video Endoscopic Sequence 3 of 18.

Extensive Neoplasia of the Duodenum

The stricture to be stented is first identified endoscopically. The proximal and distal aspects of the stricture are identified either endoscopically or, in the case of nontraversable strictures, with fluoroscopic guidance. A guidewire is advanced through the stricture, and the stent is positioned across the stricture and then deployed under fluoroscopic and/or endoscopic guidance by release of the constraining mechanism.









Fluoroscopy Stent placement which was placed with a therapeutic dual-channel video endoscope, under direct vision and fluoroscopy.

Video Endoscopic Sequence 4 of 18.

Deployment of a Duodenal Stent

Fluoroscopy Stent placement which was placed with a therapeutic dual-channel video endoscope, under direct vision and fluoroscopy.


The duodenal stent is shown in its final position

Video Endoscopic Sequence 5 of 18.

The duodenal stent is shown in its final position

 

The duodenal stent successfully placed under fluoroscopy and direct vision is observed using a dual channel therapeutic endoscope.

Video Endoscopic Sequence 6 of 18.

Image and video clip of a Duodenal Stent

A Follow-up Endoscopy next day

The duodenal stent successfully placed under fluoroscopy and direct vision is observed using a dual channel therapeutic endoscope.


Duonenal Stent

Video Endoscopic Sequence 7 of 18.

Endoscopy of Duodenal Stent

Maintenance of gastrointestinal luminal patency is of paramount importance in the treatment of patients with malignant obstruction. For both palliation of obstructive symptoms and continued oral intake, the placement of an endoprosthesis can greatly enhance the quality of life of the patient. With recent technologic advances, self-expanding metal stents (SEMS) are at the forefront of the endoscopist's armamentarium for re-establishing luminal patency.

Duodenal Stent

Video Endoscopic Sequence 8 of 18.

Image and Video clip of Duodenal Stent

The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.

 

 

 

Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 9 of 18.

Duodenal Stent

The distal end of the prosthesis is observed

Gastroduodenal stent placement is a minimally invasive technique that provides better palliation than surgery and offers several advantages: It can be performed as an outpatient procedure, allows more rapid gastric emptying, is highly cost effective, entails minimal complications, and improves the patient’s quality of life.

Video Endoscopic Sequence 10 of 18.

Duodenal Stent


Duodenal obstruction resulting from primary or metastatic cancer is a late occurrence in patients with advanced disease. Obstructive symptoms, such as nausea, vomiting, and abdominal distention, as well as nutritional deficiencies, can lead to frequent hospitalization and high morbidity.

 

Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 11 of 18.

Duodenal Stent

For palliative purposes, the main clinical goal for patients with malignant duodenal obstruction is restoration of the ability to tolerate oral diets. As the median survival duration in these patients may be as short as 3~4 months, an ideal treatment would quickly restore the oral dietary intake with few complications, and thus shorten the hospital stay, with no negative impact on survival.



Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 12 of 18.

Duodenal Stent

Proximal end of the stent

The traditional approach for palliating malignant duodenal obstruction is open gastrojejunostomy. More recently, there have been reports on the effectiveness of laparoscopic gastrojejunostomy for palliating duodenal obstruction. However, over the past decade, palliative endoscopic stenting has been increasingly performed. Many different types of UGI stents are available, and palliative endoscopic stenting is being increasingly advocated and performed

Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 13 of 18.

Proximal end of the stent

Endoscopic stent placement appears to be the safest and the most effective treatment for duodenal obstruction in patients with advanced cancer. Compared with palliative surgery, the placement of self-expandable metallic stents is associated with higher clinical success rates, less morbidity, shorter interval between the procedure and oral intake initiation, lower rate of delayed gastric emptying, and shorter hospital stay.

Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 14 of 18.

Duodenal Stent

Proximal end of the stent.




Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 15 of 18.

Duodenal Stent

Proximal end of the stent

 







Image and Video clip of Duodenal Stent

Video Endoscopic Sequence 16 of 18.

Proximal end of the stent

 

 

Video Endoscopic Sequence 18 of 18.

Image and Video clip of Magnetic Resonance

Multiple masses are seen in the abdomen and pelvis

 

 







Video Endoscopic Sequence 18 of 18.

Image and Video clip of Magnetic Resonance

Multiple masses are seen in the abdomen and pelvis


 

 

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