title: [Antral exclusion. A complement to palliative gastrojejunal shunt in pancreatic cancer].
abstract: 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.
authors.affiliation: Service de Chirurgie générale et digestive, Hôtel-Dieu, Clermont-Ferrand.
authors.forename: K
authors.initials: K
authors.lastname: Slim
authors.forename: D
authors.initials: D
authors.lastname: Pezet
authors.forename: Y
authors.initials: Y
authors.lastname: Riff
authors.forename: J F
authors.initials: JF
authors.lastname: Richard
authors.forename: J
authors.initials: J
authors.lastname: Chipponi
mesh_terms: 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
vernacular_title: L'exclusion antrale. Un complément à l'anastomose gastro-jéjunale palliative dans le cancer du pancréas.