Aim. To compare different types of self-expanding stents (partially coated or uncovered) for malignant pyloroduodenal obstruction (MPDO). Material and methods. 89 MPDO patients underwent stenting at the Botkin City Hospital (Moscow) for the period 2008—2016. The causes of malignant obstruction were: stomach cancer — 53 (59.5%), pancreatic cancer — 31 (34.8%), compression by retroperitoneal lymph nodes — 3 (3.4%), duodenal cancer — 2 (2.2%). Patients were divided into two homogeneous groups. In group 1 (32 patients) partially coated stents were used, in group 2 (57 patients) — uncovered stents. Mean age was 68.3±6.2 and 64.3±5.7 years in both groups respectively; male/female ratio 18/14 in group 1, 32/25 in group 2. Length of stricture was 51±5.1 mm in group 1, 48±4.8 mm in group 2. GOOSS score in group 1: 0—8, 1—13, 2—11, 3—0, in group 2 0—14, 1—25, 2—18, 3—0 (p=0.03). Results and discussion. Technical success was achieved in 32 patients of group 1 (100%) and in 57 patients of group 2 (100%). There were no procedure-associated complications and mortality. Clinical success was observed in 29 (90.6%) patients of group 1 and in 50 (87.7%) patients of group 2. GOOSS score of group 1: 0—8, 1—8, 2—10, 3—12, group 2: 0—3, 1—15, 2—19, 3—20. There were 3 distal dislocations of the stent within 1 — days in group 1, in group 2 dislocations were absent. Postoperative chemotherapy was prescribed in 20 (62.5%) patients of group 1 and 38 (66.7%) patients of group 2 (p=0.08). 27 patients of group 1 and 49 patients of group 2 died due to progression of the disease, others are under observation. Mean life expectancy: group 1 (18 patients — 50 days, 9 patients — 100 days, 5 patients were alive by the moment of study); group 2 (32 patients — 50 days, 100 days — 17 patients, 8 patients were alive by the moment of study). 3 patients (9.4%) in group 1 and 7 (12.3%) patients in group 2 had stent dysfunction (p=0.02). Mean period of partially covered stent function was 138±3.9 days, uncovered stent — 96±4.8 days (р=0.003). Conclusion. Our study showed that time of stent function corresponds to median survival. Greater number of stent migration in group 1 is due to stent coverage, higher incidence of stent dysfunction in group 2 — due to malignant invasion.
