Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation - 17/08/13
, Pavlos Papavasiliou, M.D., Smit Singla, M.D., M.R.C.S. (Edinburgh), M.Sc., Veeraiah Siripurapu, M.D., Tianyu Li, M.S., James C. Watson, M.D., John P. Hoffman, M.D., Jeffrey M. Farma, M.D.Abstract |
Background |
In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis.
Methods |
A retrospective review of patients undergoing PSPG for malignant obstruction from 1999 to 2011 was performed. Ability to tolerate oral intake in the postoperative period and at last follow-up was the criterion for a successful bypass.
Results |
Fifty-five patients with locally advanced or metastatic tumors underwent PSPG. The median follow-up period was 8 months. No patient developed signs of gastric outlet obstruction after PSPG. Seventy-five percent of patients had pancreatic or duodenal and 25% had nonpancreatic cancers. Nine patients developed postoperative complications. The perioperative mortality rate was zero. Median overall survival was 9 months. All patients were tolerating an enteral diet on the day of discharge, and as of the last follow-up, 95% were tolerating their enteral diets.
Conclusions |
This and a previous study from the authors' institution show that PSPG is a good alternative for palliative bypass in the setting of malignant gastric outlet obstruction over classic gastrojejunostomy.
Le texte complet de cet article est disponible en PDF.Keywords : Partial stomach-partitioning gastrojejunostomy, Malignant gastric outlet obstruction, Malignant duodenal obstruction, Palliative bypass procedures
Plan
| The authors declare no conflicts of interest. |
Vol 206 - N° 3
P. 333-339 - septembre 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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