title: Pretreatment of gastric outlet obstruction with pancrelipase: Report of a case.
abstract: BACKGROUND
  Gastric outlet obstruction is characterized by the retention of gastric contents. Removal of gastric contents is an important part of the treatment strategy. The use of a nasogastric tube alone can result in inadequate removal of gastric contents. We treated a patient with advanced gastric cancer and gastric outlet obstruction with pancrelipase to aid in the removal of gastric contents.
  
  
  METHODS
  The patient is an 81-year-old man with a Type 3 gastric cancer nearly circumferentially involving the antrum, resulting in gastric outlet obstruction. A nasogastric tube was placed for four days, but drainage of gastric contents was inadequate. Pancrelipase was then given orally for four days, and gastric contents were evacuated. The patient underwent distal gastrectomy with Roux-en-Y reconstruction and was discharged from the hospital on postoperative day 14.
  
  
  CONCLUSIONS
  This report suggests that pancrelipase may be beneficial in the treatment of patients with gastric outlet obstruction.
  
  
  CONCLUSIONS
  Pancrelipase allowed gastric contents to be evacuated in a short period of time in a patient with gastric outlet obstruction.
authors.affiliation: Department of Surgery, Isesaki Sawa Medical Association Hospital, 481, Shimoueki-cho, Isesaki, Gunma 372-0024, Japan; Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. Electronic address: ui@jichi.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ui
authors.affiliation: Department of Surgery, Isesaki Sawa Medical Association Hospital, 481, Shimoueki-cho, Isesaki, Gunma 372-0024, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shibusawa
authors.affiliation: Department of Surgery, Isesaki Sawa Medical Association Hospital, 481, Shimoueki-cho, Isesaki, Gunma 372-0024, Japan; Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tsukui
authors.affiliation: Department of Surgery, Isesaki Sawa Medical Association Hospital, 481, Shimoueki-cho, Isesaki, Gunma 372-0024, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sakuma
authors.affiliation: Department of Surgery, Isesaki Sawa Medical Association Hospital, 481, Shimoueki-cho, Isesaki, Gunma 372-0024, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Alan K
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hosoya
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sata
authors.affiliation: Department of Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
keywords: Gastric cancer; Gastric outlet obstruction; Pancrelipase