Management of gastroduodenal stent-related complications

A B S T R A C T Endoscopic placement of a gastroduodenal self-expandable metallic stent (SEMS) is a safe and minimally invasive intervention for patients with malignant gastric outlet obstruction (GOO). One major shortcoming of SEMS, however, is a frequent need for re-interventions due to stent-related complications, such as occlusion and migration. With continuing advances in oncologic therapy and improved survival in patients with malignancy, these complications may be encountered more frequently. Mild complications include abdominal discomfort, low grade fever, and occasional vomiting without obstruction. Major complications occurring within the first week include bleeding, perforation, stent migration, severe pain, fever, and jaundice. Significant late complications include fistula formation, stent obstruction, late perforation or bleeding, biliary obstruction, and stent migration. Correctly identifying and managing SEMS-related complications in a timely manner is essential in maintaining effective palliation in patients with malignant GOO. In this review article, we discuss the management of complications arising from the placement of gastroduodenal SEMS in patients with malignant GOO.