Laparoscopic
gastrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer.
Afferent loop syndrome secondary to Billroth II
gastrojejunostomy obstruction: multidetector computed tomography findings.
He had a history of OAGB (with concomitant Braun jejunojejunostomy 30 cm below the
gastrojejunostomy) 3 years ago.
Anastomotic leak in the
gastrojejunostomy anastomosis was successfully closed with application of endoscopic fibrin glue to the first two patients.
Complication rates and patency of radiologically guided mushroom gastrostomy, balloon gastrostomy, and
gastrojejunostomy: a review of 250 procedures.
Gastrojejunostomy (GJJ) is the standard palliative treatment for GOO and adequately relieves obstructive symptoms in most cases.[sup][7],[8],[9] However, the incidence of delayed gastric emptying after conventional GJJ is significant (20%–59%),[sup][10],[11],[12],[13] and the postoperative mortality rate reportedly varies from 18% to 24%.[sup][2],[13],[14] Endoscopic stenting (ES) is increasingly being performed for malignant GOO.[sup][15] With a shorter procedure time, faster resumption of oral intake, and a shorter hospital stay than GJJ, ES presents an effective and less invasive therapeutic option for the treatment of GOO.[sup][16],[17],[18] However, higher rates of complications, reintervention, and recurrent obstructive symptoms have also been reported.[sup][5],[15],[17]
Definitive management involved a total duodenectomy, followed by an end-to-end
gastrojejunostomy, choledochojejunosotomy and pancreaticojejunostomy.
Laparoscopic
gastrojejunostomy has been established as a safe alternative to open approach for the palliation of symptoms due to gastric outlet obstruction in unresectable cancer stomach.
For this, most commonly used surgical techniques used are Billroth 1(Partial gastrectomy and gastroduo-denostomy), Billroth 2 (Partial gastrectomy and
gastrojejunostomy) and total gastrectomy.
The jejunum is then divided approximately 30 to 50 cm beyond the ligament of Treitz, and the distal segment of jejunum (alimentary limb) is brought up in either an antecolic (most common nowadays) or retrocolic fashion and reattached to the small gastric pouch (
gastrojejunostomy).
The primary mass was noted to be fixed to the retroperitoneum and was not resectable; therefore, a palliative
gastrojejunostomy was performed.
A formal pancreaticoduodenectomy was performed with an end-to-end pancreaticojejunostomy, end-to-side choledochojejunostomy and an antrectomy with
gastrojejunostomy. Two Jackson-Pratt drains were left in place next to the choledochojejunal and the pancreaticojejunal anastomoses.