Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation

Abstract

BackgroundIn 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. MethodsA 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. ResultsFifty-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. ConclusionsThis 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.