Partial stomach-partitioning gastrojejunostomy for malignant duodenal obstruction

Cletus A Arciero, Natalie Joseph, James C Watson, John P Hoffman
American Journal of Surgery 2006, 191 (3): 428-32

BACKGROUND: Standard methods of palliative gastrojejunostomy lead to delayed gastric emptying in up to 67% of patients. Partial stomach-partitioning gastrojejunostomy (PSPG) allows for the preferential passage of ingested material into the jejunum while maintaining endoscopic access to the diseased region and obviating the risk of leakage after antrectomy.

METHODS: A retrospective examination of all patients undergoing PSPG from February 1999 through November 2004 was undertaken. Successful palliative bypass was based on the patient's ability to tolerate a regular diet.

RESULTS: Thirty-nine patients underwent PSPG during the study period. All patients had locally advanced or metastatic gastrointestinal tract tumors. Sixteen patients presented with obstructive symptoms. The majority of patients (97%) were tolerating a regular diet at their last follow-up.

CONCLUSIONS: PSPG is an alternative method of providing palliative bypass and allows for excellent palliation with delayed gastric emptying rates lower than that of standard gastrojejunostomy procedures.

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