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Metal Stents in Gastroenterology Kirsten Rosser, RN Gastroenterology Department

Metal Stents in Gastroenterology Kirsten Rosser, RN Gastroenterology Department. Outline. History What is a metal stent? Placement Indications for use Insertion Complications After care. History of GI Stents. 1973 Didcott (Oesophageal) 1985 Carrasco (Biliary) 1991 Dahmato (Colorectal).

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Metal Stents in Gastroenterology Kirsten Rosser, RN Gastroenterology Department

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  1. Metal Stents in GastroenterologyKirsten Rosser, RNGastroenterology Department

  2. Outline • History • What is a metal stent? • Placement • Indications for use • Insertion • Complications • After care

  3. History of GI Stents • 1973 Didcott (Oesophageal) • 1985 Carrasco (Biliary) • 1991 Dahmato (Colorectal)

  4. What is a Metal Stent?

  5. Where do we place them? • Oesophagus

  6. Oesophageal Stents - indications • Palliative care in patients with malignant obstruction of the oesophagus • Increase in nutritional intake • Minimise risk of aspiration

  7. Where do we place them? • Oesophagus • Duodenum

  8. Duodenal Stents - indications • Palliative treatment for obstruction of the duodenum • Facilitates gastric emptying • Decreases nausea and vomiting • Avoid palliative surgery

  9. Where do we place them? • Oesophagus • Duodenum • Bile duct

  10. Biliary Stents - indications • Infiltrating tumours • Palliative treatment of bile duct obstruction • Relieve symptoms of jaundice • Ascending Cholangitis

  11. Where do we place them? • Oesophagus • Duodenum • Bile duct • Colon

  12. Colonic Stents - indications • Immediate bowel decompression • Palliative treatment of large bowel obstruction • Decreased surgical morbidity • Shorter hospital admission • Decreased costs compared to colostomy/resection

  13. Preparing the patient • Information leaflets • Explaining the procedure • Answering any questions • Obtaining informed consent

  14. During the procedure - the nurses role • Monitoring vital signs • Assessing patient comfort • Maintaining patient dignity • Assisting the Doctor with placing stent

  15. How is the stent deployed?

  16. Complications associated with stent placement • Perforation • pain • bleeding • stent migration • tumour ingrowth/overgrowth • fistula formation/ulceration

  17. Care of the patient post stent insertion - immediate • NBM for 2 hours • Hourly observations - BP and pulse • Assess for pain • Clear fluids after 2 hours if no pain • Liquid diet after 4 hours • Soft diet after 24 hours • Notify Dr if any pain, bleeding or change in observations

  18. Care of the patient post stent insertion - longer term • Dietician referral • Position while eating (Oesophageal) • Patient Information leaflets • What happens if the stent blocks?

  19. Questions?

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