Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis

Objectives

To compare the outcomes between stent placement and surgical gastrojejunostomy (GJ) for the palliation of gastric outlet obstruction (GOO) in patients with unresectable gastric cancer.

Methods

A retrospective study was performed in a single university hospital in 224 patients with GOO, and who were treated either by stent placement (n?=?124) or surgical GJ (n?=?100). The outcomes were assessed with reference to the following variables with the use of propensity-score matching: success rates; complications; dysphagia scores, albumin, and body mass index; survival; symptom-free duration; and hospitalization.

Results

We identified a well-balanced cohort of 74 pairs of patients, matched on the basis of propensity score. The dysphagia score 7 days after treatment was significantly better in the stent group (P?

Conclusions

Stent placement can provide faster symptom relief and shorter hospitalization, while surgical GJ can provide longer symptom-free duration, less recurrent obstruction symptoms and better nutritional status.

Key Points

? The two methods are equally effective in palliating gastric outlet obstruction symptoms ? The stent group showed rapid and efficient palliation of symptoms ? Recurrent symptoms were more frequent in the stent group ? Surgical gastrojejunostomy provides a longer symptom-free duration and better nutritional status