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

lingua: Inglese

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


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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