Gastrojejunostomy versus duodenal stent placement for gastric outlet obstruction in patients with unresectable pancreatic cancer
Gastrojejunostomy versus duodenal stent placement for gastric outlet obstruction in patients with unresectable pancreatic cancer
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DOI：
10.1016/j.pan.2017.09.011
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发表时间：
2017-11-01
期刊：
影响因子：
3.6
通讯作者：
Yasui, Hirofumi
中科院分区：
文献类型：
--
作者：
Yoshida, Yukio;Fukutomi, Akira;Yasui, Hirofumi
背景/目的：胃空肠吻合术（GJJ）或十二指肠支架（DS）放置术是治疗不可切除胰腺癌患者胃出口梗阻（GOO）的首选方法，目前尚不清楚。我们比较了GJJ与DS放置在these patients.Methods的有用性：我们回顾性分析了66例连续的不能切除的胰腺癌患者接受GJJ或DS放置症状GOO.Results：我们分析了30例患者接受GJJ和23谁接受DS放置。腹膜转移在DS组中更常见。两组首次干预后的中位生存期相似。虽然临床成功GJJ组的GOO评分（GOO评分系统评分>2）率显著高于GJJ组，（100% vs. 81%），临床获益GJJ组和DS组之间的生存率（首次干预后一半以上的生存期保持评分>2）相似（66.7% vs. 69.7%），甚至在存活≥ 90天的患者中（73.3% vs. 75.0%）。此外，DS组首次干预后可接受计划化疗的患者比例更高，至化疗给药的时间显著更短（9 vs. 32天）。主要并发症发生率在两个groups.Conclusions：这些研究结果表明，DS放置是有效的GJJ治疗GOO患者不可切除的胰腺癌，即使在那些具有较长的预期寿命。在计划化疗的患者中，DS放置可能比GJJ更有益。(C)2017 IAP和EPC。Elsevier B. V.出版，保留所有权利。
Background/Objective: Whether gastrojejunostomy (GJJ) or duodenal stent (DS) placement is preferable for treatment of gastric outlet obstruction (GOO) in patients with unresectable pancreatic cancer is unclear. We compared the usefulness of GJJ with that of DS placement in these patients.Methods: We retrospectively reviewed 66 consecutive patients with unresectable pancreatic cancer who underwent GJJ or DS placement for symptomatic GOO.Results: We analyzed 30 patients who underwent GJJ and 23 who underwent DS placement. Peritoneal metastasis was more common in the DS group. Median survival after the first intervention was similar in both groups. Although clinical success (maintaining a GOO Scoring System score >2 for more than 7 days) rate was significantly higher in the GJJ group (100% vs. 81%), clinical benefit (maintaining a score >2 for more than half of their survival after the first intervention) rate was similar between the GJJ and DS groups (66.7% vs. 69.7%), even among patients who survived for >= 90 days (73.3% vs. 75.0%). Further, the proportion of patients who could receive planned chemotherapy after the first intervention was higher and the time to administration of chemotherapy was significantly shorter in the DS group (9 vs. 32 days). Major complication rate was similar in both groups.Conclusions: These findings suggest that DS placement is as effective as GJJ for the treatment of GOO in patients with unresectable pancreatic cancer, even in those with a long life expectancy. DS placement might be more beneficial than GJJ in patients for whom chemotherapy is planned. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.