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Panminerva Medica 1998 December;40(4):264-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

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

Premaratne S., Behling A. F.*, McNamara J. J. **

From the Hunter Holmes McGuire Veterans Administration Medical Center Gastroenterology Section (111N), Richmond, Virginia and Division of Gastroenterology Department of Internal Medicine Medical College of Virginia Virgina Commonwealth University, Richmond Virginia * Department of Human Nutrition University of Hawaii at Manoa, Honolulu, Hawaii ** Department of Surgery, John A. Burns School of Medicine University of Hawaii, Honolulu, Hawaii and Cardiovascular Research Laboratory The Queen’s Medical Center, Honolulu, Hawaii


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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.
Methods. Experi­men­tal ­design: ret­ro­spec­tive med­i­cal ­records ­review. Set­ting: Hon­olu­lu ­area teach­ing hos­pi­tal. ­Patients/par-­tic­i­pants: 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.

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