Introduction: Palliative gastrojejunostomy is a surgical technique that allows restoration of oral intake among patients with gastric outlet obstruction (GOO) caused by unresectable neoplasms. Research suggests standard treatment for malignant GOO should be laparoscopic gastrojejunostomy (LGJ). This study presents the clinical outcomes of palliative gastrojejunostomy and compares results from LGJ and open gastrojejunostomy (OGJ) at our centre.
Methods: We performed a retrospective analysis on patients who underwent palliative gastrojejunostomy for GOO caused by unresectable neoplasms between 2008 and 2018. We included demographic variables, time to recover intestinal transit, time to recover oral intake, hospital stay, complications and global survival.
Results: A total of 39 patients underwent palliative gastrojejunostomy (20 OGJ, 19 LGJ). Patients in the LGJ group recovered oral intake and intestinal transit faster than those in the OGJ group (3 vs 5 days, <0.05). There were no statistically significant differences in median operating time, hospital stay or postoperative complications between the two groups. No intraoperative complications occurred. The estimated global survival was 178 days, with no significant difference between the groups.
Conclusions: Palliative LGJ allows earlier restoration of oral intake and does not increase morbidity or mortality. Palliative LGJ should be considered the standard treatment for these patients.
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http://dx.doi.org/10.1308/rcsann.2020.7016 | DOI Listing |
Cureus
December 2024
Surgery, Memorial University of Newfoundland, St. John's, CAN.
Concurrent malignant biliary and gastric outlet obstruction requires urgent palliative intervention to improve patient quality of life and permit systemic therapy. Traditional management has been surgical gastrojejunostomy and hepaticojejunostomy, two morbid procedures. Comparatively, endoscopic stenting can relieve both sites of obstruction with less complications and quicker recovery.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Surgery, University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033, United States.
Gastric surgery may result in internal herniation of bowel, weeks to years after the initial surgery and can result in rapid onset of death if not promptly treated. We present a case in which a patient with this complication underwent surgery despite his clear refusal of surgery. The patient had a remote history of gastrectomy for malignancy.
View Article and Find Full Text PDFBMJ Support Palliat Care
December 2024
Gastrointestinal Surgery, GB Pant Hospital, New Delhi, India.
Objective: Patients with metastatic gastric cancer (MGC) may require palliative surgery to manage complications such as obstruction or bleeding. While the role of stenting in MGC is clear, the role of palliative surgery in MGC shows conflicting results.
Methods: We retrospectively reviewed clinical data of patients with MGC treated at our institution between January 2007 and December 2021.
J Gastrointest Surg
February 2025
Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, CA, United States. Electronic address:
Background: Of note, 15% to 20% of patients with duodenal or periampullary malignancies develop gastric outlet obstruction (GOO). Although small randomized trials have reported more rapid recovery and shorter hospital stay with endoscopic stenting (ES), limited studies have evaluated outcomes at a national level. The current study characterized short-term clinical and financial outcomes associated with gastrojejunostomy (GJ) vs ES in malignant GOO.
View Article and Find Full Text PDFBMJ Case Rep
November 2024
Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
The mainstay of treatment for superior mesenteric artery (SMA) syndrome involves aggressive enteral feeding distal to the area of obstruction. We present a case of palliative endoscopic ultrasound (EUS)-guided gastrojejunostomy as management of SMA syndrome in a patient with concomitant metastatic pancreatic adenocarcinoma. Following the procedure, our patient demonstrated significantly improved tolerance of oral intake.
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