Morbidity-associated factors after gastrojejunostomy for malignant gastric outlet obstruction

Abstract

Palliative care of malignant gastric outlet obstruction symptoms is critical for improved quality of life. We reviewed 66 consecutive patients with malignant gastric outlet obstruction who underwent palliative gastrointestinal bypass. The objective was to analyze morbidity and mortality-associated factors of this surgical procedure. Surgical morbidity and mortality were 39 per cent and 31 per cent, respectively. Reintervention was necessary in 16.6 per cent of cases. The only variable associated with surgical mortality was a Karnofsky score less than 80 (P = 0.02). Median survival of patients was 4 months (range, 2.11-5.9 months). Variables associated with shorter survival rates were an advanced stage of the disease and a Karnofsky score less than 80. Nine of 45 (20%) patients who survived after the gastrointestinal bypass surgery were unable to tolerate a normal diet. Palliative gastrojejunostomy in patients with malignant gastric outlet obstruction is associated with high morbidity and mortality; it is necessary to improve nonsurgical options such as endoscopic stenting.