Laparoscopic modified Devine exclusion gastrojejunostomy as a palliative surgery to relieve malignant pyloroduodenal obstruction by unresectable cancer.
BACKGROUND
Malignant pyloroduodenal obstruction by an unresectable cancer makes ingesting food or liquids impossible for patients. The patient's quality of life deteriorates rapidly, leading to a dismal prognosis. The modified Devine exclusion (MDE) method of open laparotomy has been reported to be effective in such cases.


METHODS
We performed laparoscopic MDE gastrojejunostomy in 8 cases. The patient data collected included surgical time, morbidity and mortality, length of stay, the state and duration of adequate oral ingestion, and outcome.


RESULTS
The median surgical time was 191 minutes. There were no complications postoperatively. The median postoperative stay was 7 days. In that time, feeding conditions were restored to pre-illness levels. All patients were palliated successfully using this procedure.


CONCLUSIONS
Laparoscopic MDE gastrojejunostomy allows patients to regain their ability to eat, significantly improving their quality of life. This alternative laparoscopic procedure is effective for patients whose prognosis is poor as a result of unresectable cancer.
Suzuki
On
O
Department of Surgical Oncology, Hokkaido University, Graduate School of Medicine, N-15, W-7, Kita-ku, Sapporo, 060-8648, Japan. onsuzuki@med.hokudai.ac.jp
Shichinohe
Toshiaki
T
Yano
Tomoyuki
T
Okamura
Keisuke
K
Hazama
Kazuaki
K
Hirano
Satoshi
S
Kondo
Satoshi
S
D000368:Aged; D004378:Duodenal Diseases / Q000209:etiology* / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications*; D011708:Pylorus; D013274:Stomach Neoplasms / Q000150:complications*