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Gastric outlet obstruction in carcinoma gall bladder. | LitMetric

Gastric outlet obstruction in carcinoma gall bladder.

Indian J Gastroenterol

Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital, New Delhi.

Published: August 1999

AI Article Synopsis

  • Gastric outlet obstruction can occur in advanced gall bladder cancer and sometimes requires palliative surgery, specifically gastrojejunostomy, to relieve symptoms.
  • A study reviewed 39 patients, mostly women, who underwent this procedure over nine years, with many having symptoms like jaundice and obstruction due to tumor infiltration.
  • Although complications arose, including delayed gastric emptying in eight patients, most had satisfactory outcomes and no vomiting during follow-up, indicating that gastrojejunostomy is an effective palliative intervention.

Article Abstract

Background: Gastric outlet obstruction is occasionally reported to occur in advanced gall bladder malignancy and may require palliative surgery. A review of 39 patients who required gastroenterostomy for symptomatic or incipient gastric outlet obstruction in carcinoma gall bladder is presented.

Methods: This retrospective review included 24 women and 15 men over nine years who underwent gastrojejunostomy for locally advanced neoplasms of the gall bladder.

Results: Twenty two patients with carcinoma gall bladder had symptomatic gastric outlet obstruction whereas in 17 patients gastrojejunostomy had been performed for intraoperatively assessed impending obstruction. Thirty-four patients had concomitant jaundice. In most cases, there was obstruction of the first two parts of the duodenum, mostly by direct tumoral infiltration (64%). All patients underwent anterior gastrojejunostomy, with billoenteric bypass in 15 patients. There were two postoperative deaths. Eight patients developed postoperative delayed gastric emptying; all settled on conservative management, though two patients had recurrent refractory vomiting. Thirty patients had no vomiting till a follow up ranging from 36 days to 11 months.

Conclusions: Gastric outlet obstruction may frequently complicate gall bladder cancer and a satisfactory palliation can be achieved in most patients by gastrojejunostomy.

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