Palliative enteroscopic stent placement for malignant mid-gut obstruction

Palliation of malignant small intestinal obstructions beyond the reach of conventional endoscopes for stent placement generally requires endoscopic decompression via a gastrostomy tube or a surgical bypass in patients who are operable candidates. With the advent of deep enteroscopy, palliative stent placement for mid-gut obstruction using currently available self-expandable metal stents may be feasible in selected cases. Proper patient selection and technical proficiency in deep enteroscopy and stent placement are key determinants for a successful outcome. Alternative means of stent delivery, including the percutaneous route, are also being developed, with the hope of expanding the use of stents in the mid small bowel beyond palliation.