Endoscopic palliation with duodenal stent in stage IV gastric cancer complicated by gastroduodenal stenosis

Abstract

Introduction: gastric cancer is the fifth neoplasm in frequency worldwide. Its diagnosis is usually late. Gastroduodenal stenosis is a frequent complication that determines prognosis and treatment. We have several modalities regarding the palliation of this complication. We highlight the surgical treatment by digestive bypass (gastroenteroanastomosis), and the endoscopic treatment, by placing a stent or self-expanding metal prosthesis (PMA). The objective is to present the clinical case of a patient with advanced gastric cancer complicated by gastroduodenal stenosis in whom the placement of a PMA was chosen. The comparative bibliography between both techniques is controversial. There are important studies that recommend the surgical technique over the endoscopic one, and vice versa. To this end, multiple works have been carried out. The possible benefits of endoscopic palliation are: shorter hospital stay, rapid reintroduction to the oral route. On the other hand, the clinical case presented did not benefit from the shorter hospital stay, in part, because hospitalization was necessary for medical comorbidities. He had no subsequent complications related to the procedure.
Conclusions: the choice of the technique to be used should be individualized, taking into account the patient, their comorbidities, technical resources, staff experience, and economic resources. More studies are needed to demonstrate the benefit of the most appropriate palliative technique.