Effects of gastrojejunostomy on pancreatic and gastric carcinoma, pancreatitis, gastric ulcer and other disease states of the gastro-intestinal tract.

ABSTRACT

BACKGROUND: To evaluate the palliative effects of gastrojejunostomy in patients who have been diagnosed with pancreatic and gastric carcinoma, and other disorders of the gastrointestinal tract. EXPERIMENTAL DESIGN: retrospective medical records review. SETTING: Honolulu area teaching hospital. PATIENTS/PARTICIPANTS: one hundred and thirty-nine patients, 27 of whom had diagnosed pancreatic carcinoma while the remainder had other diagnoses ranging from gastric carcinoma, gastric ulcer, and cancers of nearby anatomical structures such as the ampulla of Vater, between 1985 and 1990. RESULTS: Forty-eight percent (48%) of pancreatic cancer patients were female. The group consisted of 30% Japanese, 30% Caucasian, and 15% Hawaiians/part Hawaiians. Six (22%) underwent a Roux-en-Y gastrojejunostomy (GJ), thirteen (48%) obtained a loop GJ, while the remainder (30%) had a Whipple. Seven (26%) had a biliary bypass besides their GJ. No significant difference existed with regard to the failure of GJ, whether it was performed on a patient with pancreatic cancer or for any other diagnosis. Incidence of delayed gastric emptying was similar between the two groups. CONCLUSIONS: Gastrojejunostomy is effective in patients with pancreatic cancer, and meets the goal of effective gastro-intestinal function regardless of the initial diagnosis.