Stomach-partitioning versus conventional gastrojejunostomy for unresectable gastric cancer with gastric outlet obstruction: A propensity score matched cohort study

Am J Surg. 2024 Feb:228:206-212. doi: 10.1016/j.amjsurg.2023.09.044. Epub 2023 Oct 1.

Abstract

Background: Stomach partitioning gastrojejunostomy (SPGJ) was introduced to deal with delayed gastric emptying (DGE). This study aimed to compare the short- and long-term outcomes of SPGJ versus conventional gastrojejunostomy (CGJ).

Method: This cohort study analyzed 108 patients who underwent gastrojejunostomy for unresectable gastric cancer: 70 patients underwent SPGJ, and 38 patients underwent CGJ between 2018 and 2022. Propensity score-matched (PSM) analysis was used to balance the baseline characteristics.

Results: After PSM, there were 26 patients in each group. SPGJ group had significantly lower incidence of DGE (3.8% vs. 34.6%), vomiting (3.8% vs. 42.3%), and prokinetics requirement (11.5% vs. 46.2%). SPGJ group had significantly shorter time to solid diet tolerance (4.1 days vs. 5.7 days) and postoperative hospital stay (7.7 days vs. 9.3 days). There was no significant difference in relapse reinterventions, gastric outlet obstruction (GOO) recurrence, conversion surgery, and survival outcomes.

Conclusions: SGPJ was associated with lower rate of DGE, prokinetics requirement, and shorter time of solid diet tolerance compared to CGJ in the treatment of unresectable gastric cancer patients with GOO.

Keywords: Delay gastric emptying; Gastric outlet obstruction; Gastrojejunostomy; Stomach partitioning gastrojejunostomy.

MeSH terms

  • Cohort Studies
  • Gastric Bypass* / adverse effects
  • Gastric Outlet Obstruction* / complications
  • Gastric Outlet Obstruction* / surgery
  • Humans
  • Neoplasm Recurrence, Local / etiology
  • Palliative Care
  • Propensity Score
  • Retrospective Studies
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / surgery
  • Treatment Outcome