title: Gastrojejunostomy in patients with unresectable pancreatic head cancer - the use of Roux loop significantly shortens the hospital length of stay.
abstract: OBJECTIVE
  To evaluate the use of the Roux loop on the postoperative course in patients submitted for gastroenteroanastomosis (GE).
  
  
  METHODS
  Non-jaundiced patients (n = 41) operated on in the Department of General and Transplant Surgery in Lodz, between January 2010 and December 2011 were enrolled. The tumor was considered unresectable when liver metastases or major vascular involvement were confirmed. Patients were randomized to receive Roux (n = 21) or conventional GE (n = 20) on a prophylactic basis.
  
  
  RESULTS
  The mean time to nasogastric tube withdrawal in Roux GE group was shorter (1.4 ± 0.75 vs 2.8 ± 1.1, P < 0.001). Time to starting oral liquids, soft diet and regular diet were decreased (2.3 ± 0.86 vs 3.45 ± 1.19; P < 0.001; 3.3 ± 0.73 vs 4.4 ± 1.23, P < 0.001 and 4.5 ± 0.76 vs 5.6 ± 1.42, P = 0.002; respectively). The Roux GE group had a lower use of prokinetics (10 mg thrice daily for 2.2 ± 1.8 d vs 3.7 ± 2.6 d, P = 0.044; total 62 ± 49 mg vs 111 ± 79 mg, P = 0.025). The mean hospitalization time following Roux GE was shorter (7.7 d vs 9.6 d, P = 0.006). Delayed gastric emptying (DGE) was confirmed in 20% after conventional GE but in none of the patients following Roux GE.
  
  
  CONCLUSIONS
  Roux gastrojejunostomy during open abdomen exploration in patients with unresectable pancreatic cancer is easy to perform, decreases the incidence of DGE and lowers hospitalization time.
authors.affiliation: Dariusz Szymanski, Adam Durczynski, Michal Nowicki, Janusz Strzelczyk, Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, 0-153 Lodz, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Szymanski
authors.affiliation: Dariusz Szymanski, Adam Durczynski, Michal Nowicki, Janusz Strzelczyk, Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, 0-153 Lodz, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Durczynski
authors.affiliation: Dariusz Szymanski, Adam Durczynski, Michal Nowicki, Janusz Strzelczyk, Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, 0-153 Lodz, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Nowicki
authors.affiliation: Dariusz Szymanski, Adam Durczynski, Michal Nowicki, Janusz Strzelczyk, Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, 0-153 Lodz, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Strzelczyk
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001808:Blood Vessels / Q000473:pathology; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D005746:Gastric Emptying; D018589:Gastroparesis / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011044:Poland; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
keywords: Delayed gastric emptying; Gastroenteroanastomosis; Hospital length of stay; Roux and conventional gastroeneteroanastomosis; Unresectable pancreatic cancer