ANTRAL EXCLUSION AS AN ADJUNCT TO PALLIAT IVE GASTROJEJUNOSTOMY FOR CANCER OF THE PANCREAS

Objectives: Prophylactic gastrojejunostomy remains a controversial iss ue in the management of unrescectable pancreatic cancer, The main disa dvantage of the gastrojejunostomy being the postoperative delayed gast ric emptying (gastroparesia and circulus vitiosus through the nonobstr ucted duodenum), In the aim to reduce the effects of delayed gastric e mptying we advocated the adjunct of an antral exclusion to simplify an trectomy by eliminating antral dysfunction and duodenal circulus vitio sus, Methods: The procedure of antral exclusion was performed using a 4-row linear stapler, The gastrojejunostomy was immediately proximal t o the staples row, Results: Preliminary results in 6 patients, evaluat ed by clinical follow up, radiologic and radionucleide studies, showed no delayed gastric emptying nor other postoperative complications rel ated to this technique, Conclusion: These preliminary results are enco uraging and suggest that this procedure could improve the functional r esults of the prophylactic gastrojejunostomy.