210 Purely Endoscopic Non-Fluoroscopic Stent Placement in UGI Pathologies - Safe and Cost-Effective.

Abstract Aim To study the efficacy and success of purely endoscopically visualised stenting in UGI pathologies. Method In UGI pathologies, malignant and benign expanding stents were placed. We evolved a completely endoscopic technique under visual guidance. We did not employ reliance on markers on stents at incisors to guide the placement. majority of our stents were manufactured by Hanaro and they deployed distally first. Balloon dilation was used as and when necessary. Stent was inserted over a guide wire and deployed under endoscopic visual guidance. Over all 211 patients were treated with failure to stent in one. In leaks and Gastro-Oesophageal cancers we used stents with anti-reflux valve. In benign leaks (Post Bariatric) the stent was placed from lower oesophagus to appropriate length in LSG and into Jejunum in GBP traversing the Gastric pouch. Results One patient out of 2121 had completely occluding long irregular oesophageal cancer. and thus, had to be done with help of gastrografin under radiological guidance. 168 had G-O malignancy. 11 had Pyloric and duodenal obstruction due to cancer. There were 6 patients with leaks after G-O cancer surgery. and patients had Tracheo-Oesophageal fistula (TOF) due to malignant process. Rest of the patients (18) were stunted for Post Bariatric Leaks. 80 of the cancer patients required pre stenting Balloon dilatation. 7 patients had to undergo another procedure to reposition the stent or to add another. 161 cancer patients were treated as day cases. There was no 30-day mortality. Conclusions This is safe, effective technique that saves cost and time.