Clinical Impact of Stomach-partitioning Gastrojejunostomy with Braun Enteroenterostomy for Patients with Gastric Outlet Obstruction Caused by Unresectable Gastric Cancer

Abstract

Aim: To compare adverse events and post-therapeutic clinical courses between stomach-partitioning gastrojejunostomy with Braun enteroenterostomy (SPGJ-BEE) and endoscopic metallic stent placement (EMSP) in patients with gastric outlet obstruction (GOO) caused by unresectable gastric cancer and assess the clinical utility of SPGJ-BEE.

Patients and methods: We retrospectively reviewed clinical data of 16 and 9 patients with GOO undergoing SPGJ-BEE and EMSP, respectively.

Results: Re-obstruction caused by tumor overgrowth was identified in 3 (33.3%) out of 9 patients in the EMSP group. The GOO scoring system (GOOSS) revealed that its score after treatments was significantly higher in the SPGJ-BEE group than in the EMSP group (p<0.001). All patients in both groups received chemotherapy after treatments. The median survival times in the SPGJ-BEE and EMSP groups were 414 and 303 days, respectively.

Conclusion: Our preliminary results suggest that SPGJ-BEE provides an improved long-term quality of life and the early induction of subsequent chemotherapy related with a better prognosis in patients with GOO.

Keywords: Braun enteroenterostomy; Gastric outlet obstruction; endoscopic metallic stent placement; gastric cancer; stomach-partitioning gastrojejunostomy.