CURRENT STATUS AND FUTURE PERSPECTIVE OF ENDOSCOPIC GASTRODUODENAL STENT PLACEMENT IN PATIENTS WITH MALIGNANT GASTRIC OUTLET OBSTRUCTION

Abstract

Malignant gastric outlet obstruction (GOO) can develop by tumor invasion to the upper gastrointestinal tract, resulting in cachexia, deterioration of quality of life and poor prognosis. Endoscopic gastroduodenal stent placement is a minimally invasive therapy that is an alternative to surgical gastrojejunostomy and it has been widely used in clinical practice after approval reimbursement by Japanese health insurance in 2010. However, there are still no established criteria for treatment choice of surgical bypass or endoscopic self-expandable metallic stent (SEMS) placement according to the patientʼs condition. Moreover, debates on the ideal SEMS are required because both covered and uncovered SEMSs have inherent advantages and drawbacks. Recently, a novel treatment modality for GOO, endoscopic ultrasound-guided gastrojejunostomy using lumen-apposing metal stent, has been introduced and clinical application is awaited.