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Arrangoiz R , Papavasiliou P , Singla S , Siripurapu V , Li T , Watson JC , Hoffman JP , Farma JM
Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation
Am J Surg. 2013 Sep;206(3) :333-9
AbstractBACKGROUND: In 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. METHODS: A 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. RESULTS: Fifty-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. CONCLUSIONS: This 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.
NotesArrangoiz, Rodrigo Papavasiliou, Pavlos Singla, Smit Siripurapu, Veeraiah Li, Tianyu Watson, James C Hoffman, John P Farma, Jeffrey M United States American journal of surgery Am J Surg. 2013 Sep;206(3):333-9. doi: 10.1016/j.amjsurg.2012.11.015. Epub 2013 May 22.