title: Laparoscopic gastrojejunostomy for the treatment of gastric outlet obstruction.
abstract: OBJECTIVE
  Laparoscopic gastrojejunostomy (LGJ) has been proposed as the technique preferred over open gastrojejunostomy for relieving gastric outlet obstruction (GOO) due to malignant and benign disease. This study investigates the feasibility and safety of LGJ for GOO.
  
  
  METHODS
  A retrospective review was performed of patients who underwent LGJ at Mount Sinai Medical Center from 2004 to 2008. Patient's operative course and longterm outcomes were collected.
  
  
  RESULTS
  Twenty-eight patients were reviewed (16 had malignancy, 7 had PUD, 3 had Crohn's disease, and one had obstruction of unclear cause). Average operative time was 170 minutes, and estimated blood loss was 80cc. One case was converted to open; another had stapler misfiring. Patients regained bowel function at a median of 3 days and remained in the hospital for a median of 8 days. There were 4 major postoperative complications (14%): 1 anastomotic leak and 1 trocar-site hemorrhage requiring reoperation and 2 gastrointestinal bleeds requiring endoscopic intervention. There were 5 minor complications (18%), including a partial small bowel obstruction, 1 patient developed bacteremia, and 3 patients had delayed gastric emptying. One patient had persistent GOO requiring reoperation 3 months later.
  
  
  CONCLUSIONS
  LGJ can be performed for GOO with improved outcome and an acceptable complication rate compared to the open GJ reported in the literature.
authors: Mount Sinai School of Medicine, New York, New York, USA. Linda.zhang@mssm.edu
authors: Linda P
authors: LP
authors: Zhang
authors: Parissa
authors: P
authors: Tabrizian
authors: Scott
authors: S
authors: Nguyen
authors: Dana
authors: D
authors: Telem
authors: Celia
authors: C
authors: Divino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D017219:Gastric Outlet Obstruction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged