Abstract
Background: Gastric adenocarcinoma is one of the frequent cancers seen in Kashmir valley. Patients often present with advanced disease and Gastric Outlet obstruction (GOO). We studied the profile and management of patients presenting with malignant GOO due to Gastric cancer at our center.
 Methods: A prospective one and half year study from May 2018 to Dec 2019 was done in the Department of Surgical Gastroenterology, Government Medical College, Srinagar. All adult patients with clinical and endoscopic evidence of malignant gastric outlet obstruction and features of gastric cancer were included.
 Results: Twenty three patients with GOO due to Gastric malignancies were noted in this period with a M:F ratio of 1.9:1 and age range of 32 to 79 years. Vomiting was the most common symptom present in 83 % patients followed by early satiety which was present in 74% of cases. Though patients gave history suggestive of weight loss but only 17 % patients had a documented weight loss. Palliative gastrojejunostomy was done in 21 patients and Radical Distal gastrectomy was done in 2 patients. Surgical site infection was the most common (06 cases; 26%) complication in our group followed by delayed gastric emptying (04 cases; 17.4%) and pulmonary complications (03 cases; 13%).
 Conclusion: Gastrojejunostomy offers good palliation of symptoms in patients with GOO due to GC. It can be offered with equally good results by laparoscopic access.
Highlights
Gastric cancer (GC) is one of the leading gastrointestinal cancer related morbidity and mortality worldwide as well as in Kashmir valley and adenocarcinoma is the most common malignancy seen in the stomach, comprising 90% of all gastric cancers.[1,2,3] Early symptoms of gastric cancer are nonspecific and are often confused and treated symptomatically as acid peptic disease or chronic gastritis
We studied the profile and management of patients presenting with malignant Gastric Outlet obstruction (GOO) due to Gastric cancer at our center
Palliative gastrojejunostomy was done in 21 patients and Radical Distal gastrectomy was done in 2 patients
Summary
Gastric cancer (GC) is one of the leading gastrointestinal cancer related morbidity and mortality worldwide as well as in Kashmir valley and adenocarcinoma is the most common malignancy seen in the stomach, comprising 90% of all gastric cancers.[1,2,3] Early symptoms of gastric cancer are nonspecific and are often confused and treated symptomatically as acid peptic disease or chronic gastritis. We intended to study the profile and surgical management of patients presenting to us with malignant GOO due to gastric cancer. Patients often present with advanced disease and Gastric Outlet obstruction (GOO). We studied the profile and management of patients presenting with malignant GOO due to Gastric cancer at our center. All adult patients with clinical and endoscopic evidence of malignant gastric outlet obstruction and features of gastric cancer were included. Conclusion: Gastrojejunostomy offers good palliation of symptoms in patients with GOO due to GC. It can be offered with good results by laparoscopic access.
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