[Antral exclusion. A complement to palliative gastrojejunal shunt in pancreatic cancer].
OBJECTIVE
Prophylactic gastrojejunostomy remains a controversial issue in the management of unresectable pancreatic cancer. The main disadvantage of the gastrojejunostomy being the postoperative delayed gastric emptying (gastroparesia and circulus vitiosus through the nonobstructed duodenum). In the aim to reduce the effects of delayed gastric emptying we advocated the adjunct of an antral exclusion to simplify antrectomy by eliminating antral dysfunction and duodenal circulus vitiosus.


METHODS
The procedure of antral exclusion was performed using a 4-row linear stapler. The gastrojejunostomy was immediately proximal to the staples row.


RESULTS
Preliminary results in 6 patients, evaluated by clinical follow up, radiologic and radionucleide studies, showed no delayed gastric emptying nor other postoperative complications related to this technique.


CONCLUSIONS
These preliminary results are encouraging and suggest that this procedure could improve the functional results of the prophylactic gastrojejunostomy.
Slim
K
K
Service de Chirurgie générale et digestive, Hôtel-Dieu, Clermont-Ferrand.
Pezet
D
D
Riff
Y
Y
Richard
J F
JF
Chipponi
J
J
D000713:Anastomosis, Roux-en-Y; D006801:Humans; D007583:Jejunum / Q000601:surgery; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011706:Pyloric Antrum / Q000601:surgery*; D013270:Stomach / Q000601:surgery; D013528:Surgical Staplers
L'exclusion antrale. Un complément à l'anastomose gastro-jéjunale palliative dans le cancer du pancréas.