The management of gastric outlet obstruction secondary to inoperable cancer

Background: Historically, the distressing symptoms of malignant gastric outlet obstruction have been best managed by open gastrojejunostomy. We provide an assessment of an alternative laparoscopic technique. Methods: We reviewed eight patients undergoing laparoscopic gastrojejunostomy. Patient data included age, sex, operation time, morbidity and mortality, length of stay, and outcome at 6 months where possible. Results: There were six men and two women, their median age was 67 years. Median operating time was 135 min, median time to solid food was 4 days, and median postoperative stay was 7 days. Seven of our eight patients were palliated successfully using this technique. Conclusion: The risks inherent in operating on these patients, who are by definition in a poor state of health, has encouraged much interest in minimal access surgery. We conclude that laparoscopic gastrojejunostomy provides effective palliation of gastric outlet obstruction, and we recommend further evaluation of this technique.