1 / 19

화순전남대학교병원 영상의학과 혈관조영 & 인터벤션실 * 김종학 , 김현석 , 최연상 , 박 혁 , 김종덕 , 김경묵 , 선종백

Malignant gastroduodenal 로 인한 Gastric outlet obstruction 에 separate gastroduodenal stent insertion 의 유용성에 관한 고찰. 화순전남대학교병원 영상의학과 혈관조영 & 인터벤션실 * 김종학 , 김현석 , 최연상 , 박 혁 , 김종덕 , 김경묵 , 선종백. Introduction.  Gastric outlet obstruction.

katell-reynolds
Download Presentation

화순전남대학교병원 영상의학과 혈관조영 & 인터벤션실 * 김종학 , 김현석 , 최연상 , 박 혁 , 김종덕 , 김경묵 , 선종백

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Malignant gastroduodenal로 인한 Gastric outlet obstruction에 separate gastroduodenal stent insertion의 유용성에 관한 고찰 화순전남대학교병원 영상의학과 혈관조영 & 인터벤션실 *김종학, 김현석, 최연상, 박 혁, 김종덕, 김경묵, 선종백

  2. Introduction  Gastric outlet obstruction • Common clinical manifestation in benign or malignant disease of distal stomach, duodenum, and pancreatic area • Cause - Gastric and pancreatic carcinoma - Lymphoma - Biliary cancer - Metastasis to duodenum or jejunum - Extrinsic compression • Clinical Presentation • - Nausea, Vomiting, Malnutrition •  “Food fear”

  3. Introduction  Malignant Gastroduodenal obstruction • Average survival time : 3~4 months • Minimally invasive but effective palliation method is required • Surgical palliation • - Standard palliation method • Associated with high complication rate • ; Poor general condition, Malnutrition state • Stent insertion

  4. Introduction  Gastroduodenal Stent • 1992, Gastroduodenal stent – Bare stent - tumor ingrowth, gronulation tissue formation  Restricture • 1999, Covered gastorguodenal stent - Migration(21~26%), biliary obstruction  Self-expanding separate gastroduodenal stent

  5. Indications  Gastroduodenal Stent • Gastric, duodenal, and proximal jejunal malignant obstructions caused by non-resectable tumors • Obstruction by recurred lesion after previous surgical anastomosis • Benign obstruction patient with surgical risk

  6. Technique •  UGI • - Useful for identifying length and location of stricture •  CT • - Tumor staging • - Provide valuable information concerning location of • stricture and possible additional level of obstruction

  7. Case 1 ¶남 / 77 ¶임상소견:  No water and food ¶진 단 명 : Malignant stomach  - Gastroduodenal  obstruction

  8. Case 1

  9. Case 1

  10. Case 1

  11. Case 1

  12. Case 2 ¶남 / 70 ¶임상소견:  No water and food, vomiting ¶진 단 명: Gastric cancer-chemotherapy

  13. Case 2

  14. Case 2

  15. Case 2

  16. Case 2

  17. Case 2

  18. Consideration • we could know that patient inserted separate • gastroduodenal stent could take ingestper oral by removing gastric oulet obstruction, recovered solwly and gained in weight. • Recently endoscopic self-expanding stent has been attempted, but in gastric outlet obstruction disease, we could know that this procedure itself was not achieved because endoscopic approach was difficult.

  19. Conclusion •  Separate gastroduodenal stent placement is very safe and effective palliation method in patients with unresectable malignant tumors causing gastric outlet obstruction • - High technical success rate • - Less invasive • - More cost effective than surgical prcedure

More Related