ArticleSurgical endoscopy2026
Endoscopic multi-stent placement for combined malignant gastric outlet and distal biliary obstruction; 12-year experience at a tertiary endoscopic center.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
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10 authors.
Funding
Abstract
BACKGROUND AND
aimThe palliative treatment of malignant dual obstruction involving the distal biliary obstruction (DBO) and the gastric outlet obstruction (GOO) presents a complex and common clinical challenge. This study aims to analyze the clinical experience and therapeutic efficacy of endoscopic multi-stent placement in these patients. PATIENTS AND
methodsWe conducted a retrospective cohort study involving 150 patients with unresectable malignancies presenting with concurrent GOO and DBO. All patients underwent endoscopic multi-stent placement at the General Hospital of Northern Theater Command between June 2012 and December 2024. Procedural outcomes include technical success rates, clinical effectiveness, and post-operative complications. Logistic regression analyses were performed to identify independent risk factors associated with suboptimal clinical outcomes following duodenal stenting.
resultsThe cohort comprised 150 patients who underwent a total of 152 endoscopic retrograde cholangiopancreatography (ERCP) procedures for endoscopic multi-stent placement. Procedural outcomes demonstrated varying technical success rates across stent types: 94.5% (142/150) for biliary stents, 100% (150/150) for duodenal stents, and 90% (62/69) for pancreatic stents. Corresponding clinical success rates were 93% (132/142), 87%, and 98% (59/60), respectively. Univariate and stepwise logistic regression analysis identified two significant predictors of duodenal stent dysfunction: metastatic disease burden (OR 3.34, 95% CI 1.12-11.42; p = 0.038) and an obstruction length exceeding 5 cm (OR 4.23, 95% CI 1.40-12.74; p = 0.010). The safety profile included procedure-related adverse events: post-ERCP pancreatitis (4%, 6/150), cholangitis (4%, 6/150), perforation (1, 0.67%), and death (7, 4.7%).
conclusionEndoscopic multi-stent placement demonstrated high safety and efficacy for palliating combined malignant GOO and DBO. Tumor metastasis and long-segment obstruction (≥ 5 cm) serve as independent predictors of suboptimal efficacy of duodenal stent.
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