title: Is modified Devine exclusion necessary for gastrojejunostomy in patients with unresectable pancreatobiliary cancer?
abstract: OBJECTIVE
  Gastrojejunostomy is often performed as palliative surgery for unresectable pancreatobiliary cancer. Modified Devine exclusion (MDE) is a technical variation of gastrojejunostomy, which partially separates the mid-portion of the stomach. We conducted this study to assess whether MDE is necessary for gastrojejunostomy in patients with unresectable pancreatobiliary cancer.
  
  
  METHODS
  We compared the postoperative results of MDE (n = 26) with those of conventional gastrojejunostomy (CGJ; n = 20) performed palliatively for unresectable pancreatobiliary cancers.
  
  
  RESULTS
  The morbidity rates were 38% after MDE and 50% after CGJ, with 23% and 40% of patients suffering delayed gastric emptying, respectively. Two of the CGJ group patients could never eat again. Modified Devine exclusion slowed the progression of anemia in all of the patients with duodenal bleeding.
  
  
  CONCLUSIONS
  Modified Devine exclusion may be effective for patients with unresectable pancreatobiliary cancer.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Usuba
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Toyama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishii
authors.forename: Satoru
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome