Delayed return of gastric emptying after gastroenterostomy

Abstract

A retrospective study of patients having gastroenterostomies was undertaken to identify predictive factors for the development of postoperative delayed return of gastric emptying (DRGE). A total of 322 consecutive patients underwent 324 gastroenterostomies; 35 experienced delayed return of gastric emptying. Regression analysis demonstrated preoperative obstruction to be the most significant factor (P less than 0.001). Vagotomy was not an independent variable. Age, sex, size of stoma, anastomotic technique, albumin and experience of the operator were not significant factors. Gastroenterostomy in the presence of 'gastric atony' was likely to produce DRGE. In all, 86 per cent of cases resolved spontaneously. Only one case of DRGE was found to have a mechanical cause. Most patients were supported by parenteral nutrition but, with a knowledge of the identified risk factors, more thought could be given to establishing a route for jejunal feeding at the time of surgery.

Endoscopic stenting versus surgical gastroenterostomy for palliation of malignant gastroduodenal obstruction: a meta-analysis

“…19,20 One of the commonly reported morbidities associated with GE is delayed gastric emptying, which occurs in 20%-40% of cases and can cause clinical failure. 21,22 This complication might be due to diminished motility in the dilated stomach and the unphysiologic passage of food. In contrast, in ES, the symptoms resolved within a relatively short period of time, ranging from 1 to 7 days (mean, 4 days); further, rapid resumption of oral intake was possible.…”

Modified Devine Exclusion with Vertical Stomach Reconstruction for Gastric Outlet Obstruction: A Novel Technique

“…1,2 However, this procedure has been associated with a significant DRGE in 10%-21% of all cases. 3,4 Exclusional gastrojejunostomy was originally developed by Devine 5 in 1925 as a method of antral exclusion and complete stomach division in the management of difficult duodenal ulcers. However, Devine exclusion bears the risk of a blowout of the distal gastric remnant.…”

“…1,2 The aim of this conventional procedure is to enable the resumption of sufficient oral intake, which has, however, been associated with significantly delayed return of gastric emptying (DRGE) in 10% to 21% of patients on whom it is performed. 3,4 Exclusional gastrojejunostomy was originally developed by Devine 5 in 1925 as a method for antral exclusion and complete stomach division in the management of difficult duodenal ulcers. However, Devine exclusion carries the risk of a blowout of the distal gastric remnants.…”

Laparoscopic-assisted Stomach-partitioning Gastrojejunostomy for the Palliation of Gastric Outlet Obstruction From Antral Gastric Cancer

“…2 This procedure has been associated with a significant delay in the return of gastric emptying in 10% to 26% of patients. 2,3 It is considered that the delay in gastric emptying is attributed to the inability to devise a more dependent procedure for gastrojejunostomy and to early submucosal involvement of the anastomosis by the tumor. As gastric bypass is a palliative surgery, we should consider restoring adequate oral intake, thereby promoting a better quality of life.…”