Gastroduodenal obstruction is most common with malignant lesions. Lesions causing gastroduodenal malignant obstruction include gastric cancer, duodenal cancer, pancreatic cancer, hepatobiliary or other tumor infiltration metastasis, and gastrointestinal anastomosis tumor recurrence. The clinical manifestations mainly include abdominal distension, abdominal pain, vomiting, etc. Due to vomiting and inability to eat, it often causes malnutrition and water-electrolyte balance disorder. The traditional method for patients who cannot undergo radical surgery is to perform gastrointestinal short-circuit surgery or gastrostomy or enterostomy, but at this time, patients are often in poor general condition and cannot tolerate surgery or are unwilling to operate, so they can only rely on gastrointestinal decompression and intravenous nutrition to maintain their lives. The treatment of gastroduodenal malignant obstruction with self-expanding metal endoprosthesis rapidly and effectively opens the natural feeding channel of patients, relieves symptoms, improves survival and quality of life, and has the characteristics of minimally invasive operation, safety, quick effect, less complications and wide indications compared with traditional surgical rerouting surgery, and achieves better treatment effect than surgical operation and intravenous nutrition.
Metal stent placement in patients with malignant obstruction of the gastroduodenum has achieved good results. Gastrointestinal decompression must be performed before treatment, and intraoperative guidewire passage through the stenosis is the key, and after passage through the stenosis, the guidewire catheter exchange technique is used to replace it with a superhard exchange guidewire.
Figure 1 Upper gastrointestinal tract angiography shows increased gastric volume, gastric retention, narrowing of the gastroduodenal anastomosis, mucosal rupture, and obstruction of contrast passage. Figure 2 After the metal stent was placed, it was seen that the stent was well positioned, the stent expanded well, and the contrast medium passed smoothly. The patient’s obstructive symptoms were relieved and he could eat normally.