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Gastrojejunostomy versus stent placement in patients with malignant gastric outlet obstruction: a comparison in 95 patients
Author(s) -
Jeurnink S.M.,
Steyerberg E.W.,
Hof G. van 'T,
van Eijck C.H.J.,
Kuipers E.J.,
Siersema P.D.
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20828
Subject(s) - medicine , gastric outlet obstruction , stent , surgery , incidence (geometry) , randomized controlled trial , quality of life (healthcare) , retrospective cohort study , palliative care , palliative treatment , nursing , physics , optics
Aim Gastrojejunostomy (GJJ) and duodenal stent placement are the most commonly used palliative treatment modalities for gastric outlet obstruction (GOO). In this retrospective study, we compared GJJ and stent placement with regard to medical effects. Methods Medical records of 95 patients who had undergone palliative treatment between 1994 and 2006 in a Dutch university hospital, were reviewed. Study outcomes were improvement of food intake, complications, persistent and recurrent symptoms, re‐interventions, hospital stay, and survival. Results Fifty‐three patients were referred for duodenal stent placement and 42 patients underwent GJJ. There were no differences in technical and clinical success and the incidence of minor and early major complications and survival. Food intake improved more rapidly after stent placement than GJJ ( P = 0.01). The time to late major complications, recurrent obstructive symptoms and re‐intervention was significantly shorter after stent placement than GJJ ( P = 0.004, 0.002, and 0.004, respectively). Hospital stay was also shorter after stent placement than GJJ ( P < 0.001). Conclusion These findings suggest that stent placement is associated with better short‐term outcomes and GJJ with better long‐term outcomes. A large randomized controlled trial is however needed to systematically compare stent placement with GJJ with regard to medical effects, quality of life and costs. J. Surg. Oncol. 2007;96:389–396. © 2007 Wiley‐Liss, Inc.