The Added Value of Partial Stomach-partitioning to a Conventional Gastrojejunostomy in the Treatment of Gastric Outlet Obstruction.

Ernberg, Annika; Kumagai, Koshi; Analatos, Apostolos; Rouvelas, Ioannis; Swahn, Fredrik; Lindblad, Mats; Lundell, Lars; Nilsson, Magnus; Tsai, Jon A

INTRODUCTION Poor results have been reported after conventional gastrojejunostomy (CGJ) as palliative surgical bypass treatment of gastric outlet obstruction (GOO). Partial stomach-partitioning gastrojejunostomy (PSPGJ) has been introduced as an alternative surgical treatment of GOO to reduce the risk of postoperative delayed gastric emptying (DGE). AIM The aim was to study PSPGJ as an alternative to CGJ in the treatment of GOO, with respect to DGE. PATIENTS AND METHODS A retrospective cohort study was completed in all patients who underwent a bypass of the duodenum via PSPGJ or CGJ due to GOO. Cases where concomitant biliary or bariatric procedures were performed were excluded. RESULTS Twenty-four patients met the inclusion criteria for the study; ten cases underwent PSPGJ and 14 CGJ. The incidence of DGE grade B-C was significantly lower in the PSPGJ group (0 %) compared with the CGJ group (42.9 %, p = 0.024). Oral nutrition only was recorded more often at follow-up in the PSPGJ group (9/9, 100 %) than in the CGJ group (4/13, 30.8 %) (p = 0.002). CONCLUSION PSPGJ seems to be followed by a lower rate of DGE compared to CGJ.