Laparoscopic gastrojejunostomy in patients with obstruction of the gastric outlet secondary to advanced malignancies.

Overview

Surgical palliation is an important therapeutic goal in patients with gastric outlet obstruction from cancer. The use of laparoscopic approaches for this condition has not been well studied. Our objective is to compare surgical outcomes of laparoscopic and open gastrojejunostomies in patients with gastric outlet obstruction secondary to advanced malignancies. We did a retrospective review of 20 patients who underwent a palliative gastrojejunostomy as their primary surgical procedure. There were 10 patients in the laparoscopic group and 10 patients in the open one. We identified no significant difference between groups in mean surgery time (116 vs 116 minutes) (P = 0.99), blood loss (23 vs 142 mL) (P = 0.19), or length of stay (8 vs 14 days) (P = 0.14). We also identified no difference in median time to tolerate a regular diet (7 vs 8 days) (P = 0.49) and median survival (11.2 vs 9.0 months) (P = 0.83). Delayed gastric emptying was the most common complication occurring in four patients. There is no detectable difference in surgical outcomes between laparoscopic and open gastrojejunostomies in the management of patients with obstruction of the gastric outlet secondary to cancer. Laparoscopic gastrojejunostomy is a safe and feasible operation in this setting.