Abstract
Traditionally, benign diseases were responsible for most of the causes of gastric outlet obstruction (GOO), but in recent years, 50-80% could be attributable to malignancy. Malignancy includes distal gastric cancer and hepatobiliary-pancreatic (HBP) neoplasms. In metastatic/unresectable HPB tumors, GOO decrease quality of life and treatment should be necessary. Options are duodenal stent or gastrojejunostomy (GJ), but there is no consensus. In benign diseases, 1-5% of patients with chronic pancreatitis (PC) would develop GOO. We retrospectively review all consecutive patients who underwent laparoscopic GJ for GOO due to CP or advanced HBP cancer at University Hospital of Guadalajara, Spain. We studied 10 patients with laparoscopic GJ. HBP neoplasms: Age: 78,01±6,8 years. Albumin: 28,36 ±2,7. No patient received prior chemo. Tabled 1EP02F-021 TableAge/SexGOOSSClinical successTime to initiate intakeLOS (days)Duration of food intake77/F0Yes412402 (until death)76/M3Yes312228(until death)91/F0Yes15278 (until death)78/F0Yes3107868/M0YesND128276/M0YesND13220 (until death)76/F0YesND5ND Open table in a new tab CP: 3 males. Age: 56,2±3,4. Median albumin: 37,7±6,6. Clinical success: 100%. Median LOS: 6,33±0,6. Previous literature on GOO treatment mixes different causes with different prognosis, so level of evidence is low. In benign diseases, such as CP, data are limited and patients typically requires surgical GJ. In malignancy, literature on GJ showed better long-term relief and lower reintervention rates. In other hand, stents are associated with lower hospital stay, faster initial relief and shorter time to intake, with more recurrent symptoms. Survival is essential for the choice of treatment. In HBP neoplasms, chemotherapy has increased survival. Stent is usually preferred in patients with poor general condition or life expectancy of less than 90 days but more studies are needed to standardize treatment. Laparoscopic GJ is a feasible, safe and efficient technical option.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
