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The Stomach
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Distal gastric cancer can be palliated by a distal subtotal gastrectomy which need not to be radical. The reconstruction should be via an antecolic gastrojejunostomy. If such a lesion is not resectable, a proximal gastrojejunostomy may be considered. However, the majority of these do not function. This led surgeons to consider a feeding jejunostomy with prolongation of agony, or no surgical palliative maneuver for such terminal patients.
Gastroenterology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Artificial feeding devices used are: Initially nasogastric tube.Gastrostomy may be inserted if support is likely to be needed for several months or years (Fig. 9.46).Nasojejunal tube if the patient is unable to tolerate feeding via the stomach.Gastrojejunostomy.Jejunostomy for longer-term small intestinal feeding.
Upper GI Crohn’s Disease
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Diane Mege, Janindra Warusavitarne, Yves Panis
Gastrojejunostomy is usually performed in a retrocolic fashion. Gastroduodenostomy requires adequate mobilisation of the duodenum to achieve an anastomosis to the distal stomach. When the stomach is involved, the gastrojejunostomy is more frequently performed than gastroduodenostomy (see Table 60.5).
Quality of life after total pancreatectomy with islet autotransplantation for chronic pancreatitis in Japan
Published in Islets, 2023
Tadashi Takaki, Daisuke Chujo, Toshiaki Kurokawa, Akitsu Kawabe, Nobuyuki Takahashi, Kyoji Ito, Koji Maruyama, Fuyuki Inagaki, Koya Shinohara, Kumiko Ajima, Yzumi Yamashita, Hiroshi Kajio, Mikio Yanase, Chihaya Hinohara, Makoto Tokuhara, Yukari Uemura, Yoshihiro Edamoto, Nobuyuki Takemura, Norihiro Kokudo, Shinichi Matsumoto, Masayuki Shimoda
All patients underwent TP, which was performed using the standard technique. The pancreas was often atrophic, fibrotic, hard, and adherent to the surrounding tissue. The splenic artery and/or gastroduodenal artery were preserved until just before pancreatic resection to minimize the warm ischemia time. The spleen was resected in all cases. The pancreas was transported by the two-layer method28 after intraductal organ preservation29 and delivered to the cell processing facility for islet isolation. The gastrointestinal tract was reconstructed by simultaneous gastrojejunostomy and choledochojejunostomy. If necessary, a jejunal tube was placed for postoperative nutritional support. The patient then remained in the operating room with an open abdomen until islet transplantation.
Analysis of prognostic factors in patients with self-expandable metallic stents for treatment of malignant gastric outlet obstruction
Published in Scandinavian Journal of Gastroenterology, 2023
Yoshiko Nakano, Yoshinori Mizumoto, Bunji Endoh, Tsubasa Shimogama, Satoru Iwamoto, Naoki Esaka, Yoshiyuki Ohta, Katsuyuki Murai, Masaki Murata, Shin’ichi Miyamoto
A previous multicenter randomized trial recommended gastrojejunostomy and stent placement for patients with a life expectancy of ≥2 months and <2 months, respectively, because of recurrent obstructive symptoms and a need for additional intervention in the stent group [7]. In the present study, the median OS of all patients was 65 days (range, 2–1011 days), and in the cohorts with chemotherapy after SEMS placement, it was 182 days (range, 23–1011 days), which was significantly longer. Fifty-two of 191 patients (27%) who could be followed up after SEMS placement experienced stent dysfunction. However, all patients except three, who underwent gastrojejunostomy, were managed using additional endoscopic intervention. This finding suggests that SEMS can be a promising therapeutic option not only for patients with short life expectancy but also for those who are eligible for the following chemotherapy and for whom increased life expectancy can be expected. SEMS is considered advantageous in terms of less invasiveness and shorter time required for recovery from GOO, which allow early initiation of systemic chemotherapies. In recent years, advances have been made in chemotherapy, which will enable the extension of life prognosis after treatment for GOO. Furthermore, gastrojejunostomy cannot be indicated for gastric cancers that spread into the gastric body because there is not enough space to perform the anastomosis. Thus, the fact that SEMS followed by chemotherapy prolongs the prognosis and its impact is strong especially in gastric cancer is of greater significance for these patients.
Linear Stapler versus Circular Stapler for Patients Undergoing Anastomosis for Laparoscopic Gastric Surgery: A Meta-Analysis
Published in Journal of Investigative Surgery, 2022
Tao Jin, Han-Dong Liu, Ze-Hua Chen, Jian-Kun Hu, Kun Yang
Overall, patients with gastric cancer underwent esophagojejunostomy or gastroduodenostomy, while patients with obesity underwent gastrojejunostomy. The development of strictures after finishing gastrojejunostomy is a common complication of laparoscopic RYGB, with a reported incidence between 0.8% and 33% [46–49]. Our study showed that patients receiving LSs could have a reduced incidence of anastomotic stricture, which was similar to the results of the previously performed randomized controlled trial (RCT) [16]. When we choose LSs, a wider diameter of the anastomosis can be secured because the stapler must be inserted longitudinally, which might account for the lower incidence of anastomotic strictures. However, our meta-analysis based on prospective studies demonstrated no significant difference; the few studies describing anastomotic stricture possibly impacted our study results. Therefore, further research is required in this regard.