Laparoscopic gatrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer

Abstract

Laparoscopic GJ for the palliation of unresectable advanced gastric cancer can achieve excellent results with less suppression of immune function, lower morbidity, greater improvement of hemodynamic activities, and earlier recovery of bowel movements than OGJ.

Effective palliation and quality of life outcomes in studies of surgery for advanced, non-curative gastric cancer: a systematic review

“…Nine articles met the eligibility requirements and were included in the review (Fig. 1) [12][13][14][15][16][17][18][19][20]. All included articles were retrospective, single-institution case series, except for one [19] that included a prospective collection of patient-reported outcomes for a subset of patients using a questionnaire ( Table 1).…”

“…One study reported specifically the absence of symptoms in 13.2% of non-curatively managed patients [13]. An additional 3 of the 9 studies reported that all patients had unresectable, symptomatic gastric outlet obstruction (GOO) requiring palliation [14][15][16].…”

“…Instead, hospital chart abstraction and follow-up visits were used to collect palliative clinical endpoints in 8 studies [12][13][14][15][16][17][18]20] and an unvalidated questionnaire was used to collect information in 1 study [19]. Time to oral intake was the most common outcome used and it was reported in 5 of the 9 studies (Table 2).…”

“…Time to oral intake was the most common outcome used and it was reported in 5 of the 9 studies (Table 2). Results ranged from a median of 2.9 days (laparoscopic gastrojejunostomy) [14] to 8 days (surgical bypass) [16]. One study reporting on the management of GOO through surgical bypass noted that one patient was not able to return to a normal, solid diet due to complications incurred during the surgical bypass procedure [16,20].…”

“…Good palliation for bleeding, defined as a patient not requiring a blood transfusion after the procedure until death or time of last follow-up, was described in 83% of patients receiving gastrectomy and 80% of patients receiving surgical bypass [13]. Choi [14] measured mean postoperative analgesic intake as a surrogate of relief of pain and stated that patients undergoing laparoscopic surgical bypass consumed less analgesic (430 mg) than those undergoing open surgical bypass (540 mg).…”