Laparoscopic-assisted Stomach-partitioning Gastrojejunostomy for the Palliation of Gastric Outlet Obstruction From Antral Gastric Cancer

Abstract

Conventional gastrojejunostomy is performed for gastric outlet obstruction; however, we have experience of some patients for whom oral intake was not adequately restored. Open stomach-partitioning gastrojejunostomy is a useful technique for the relief of unresectable and obstructing antral gastric cancers. We herein report the successful laparoscopic application of this technique in 2 patients: a 62-year-old male and a 65-year-old female with obstructing antral gastric cancer. There were no operative complications, and blood loss was minimal. Oral fluid intake was resumed 3 and 4 days postoperatively. Chemotherapy by oral administration was possible for each patient. There was no recurrence of the gastric outlet obstruction in either patient up until they died 6 and 10 months after surgery. Laparoscopic stomach-partitioning gastrojejunostomy is a safe and useful technique for treating unresectable and obstructing antral gastric cancer, allowing the possibility of adequate oral intake and permitting the administration of anticancer drugs.

Clinical Impact of Stomach-partitioning Gastrojejunostomy with Braun Enteroenterostomy for Patients with Gastric Outlet Obstruction Caused by Unresectable Gastric Cancer

“…On the other hand, gastrojejunostomy (GJ) is one of the surgical palliative treatments available for patients with GOO caused by unresectable tumors, such as gastric cancer, duodenal cancer and pancreatic cancer. Although GJ had conventionally been performed using hand-sewn sutures, circular or linear stapled GJ has become more common due to recent advances in surgical apparatuses and an increase in laparoscopic surgical approaches (6). Furthermore, GJ, using these staplers, may produce convenient anastomosis in laparoscopic surgery (6).…”

“…Although GJ had conventionally been performed using hand-sewn sutures, circular or linear stapled GJ has become more common due to recent advances in surgical apparatuses and an increase in laparoscopic surgical approaches (6). Furthermore, GJ, using these staplers, may produce convenient anastomosis in laparoscopic surgery (6).…”

“…Therefore, novel surgical methods have been developed in order to avoid DGE after GJ. Several investigators have demonstrated the clinical utility of stomach-partitioning gastrojejunostomy (SPGJ) in patients with GOO (6,(9)(10)(11). They demonstrated that SPGJ is an effective surgical approach to prevent DGE and tumor bleeding by food contact (9)(10)(11).…”