[A case of pyloric or antral malignant stenosis treated with arterial infusion chemotherapy and palliative therapy--self-expandable metal stents through gastrostomy].

The patient is a 62-year-old woman. She had type 3 advanced stomach cancer that was judged to have caused complete stricture of the pylorus, and to be inoperable. She received percutaneous endoscopic gastrostomy (PEG) for decompression. She also received arterial infusion chemotherapy with 5-FU, methotrexate (MTX) and cisplatin (CDDP). As a result, the pylorus stricture was reduced somewhat. We tried a self-expandable metal stent (EMS) after obtaining informed consent. A guide-wire passed in gastrostomy was introduced to the pyloric or antral stenosis manually under x-ray fluoroscopy and endoscopy. Next the EMS was introduced to the position of the stenosis over the positioned guide-wire, and then it was released. The EMS did not migrate after placement and the quantity of meals she could consume was considerably improved. She could take meals for three months after stenting. Bypass procedure is often performed for patients with advanced stomach cancer with pylorus stricture, but we thought we could help the patient maintain a good quality of life (QOL) by pylorus stenting in combination with arterial infusion chemotherapy.