title: Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation.
abstract: BACKGROUND
  In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis.
  
  
  METHODS
  A retrospective review of patients undergoing PSPG for malignant obstruction from 1999 to 2011 was performed. Ability to tolerate oral intake in the postoperative period and at last follow-up was the criterion for a successful bypass.
  
  
  RESULTS
  Fifty-five patients with locally advanced or metastatic tumors underwent PSPG. The median follow-up period was 8 months. No patient developed signs of gastric outlet obstruction after PSPG. Seventy-five percent of patients had pancreatic or duodenal and 25% had nonpancreatic cancers. Nine patients developed postoperative complications. The perioperative mortality rate was zero. Median overall survival was 9 months. All patients were tolerating an enteral diet on the day of discharge, and as of the last follow-up, 95% were tolerating their enteral diets.
  
  
  CONCLUSIONS
  This and a previous study from the authors' institution show that PSPG is a good alternative for palliative bypass in the setting of malignant gastric outlet obstruction over classic gastrojejunostomy.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA, USA. rodrigo.arrangoiz@me.com
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Arrangoiz
authors.forename: Pavlos
authors.initials: P
authors.lastname: Papavasiliou
authors.forename: Smit
authors.initials: S
authors.lastname: Singla
authors.forename: Veeraiah
authors.initials: V
authors.lastname: Siripurapu
authors.forename: Tianyu
authors.initials: T
authors.lastname: Li
authors.forename: James C
authors.initials: JC
authors.lastname: Watson
authors.forename: John P
authors.initials: JP
authors.lastname: Hoffman
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Farma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000473:pathology* / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D017219:Gastric Outlet Obstruction / Q000473:pathology* / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Malignant duodenal obstruction; Malignant gastric outlet obstruction; Palliative bypass procedures; Partial stomach-partitioning gastrojejunostomy