Laparoscopic gastrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer

Seventy-eight gastrojejunostomies were done at the Asan Medical Center for palliation of gastric outlet obstruction caused by advanced gastric, duoden al, papilla of vater and pancreatic cancer. Sixty-eight patients with advan ced gastric cancer underwent open gastrojejunostomy (OGJ, n=38) and laparos copic gastrojejunostomy (LGJ, n=30). Of those ten OGJ patients were compare d with ten LGJ for several variables. There were no significant differences between OGJ and LGJ in gender, age, A SA grading, and previous abdominal surgery. In OGJ, antecolic isoperistalti c GJ was done in ten cases, but eight antecolic and two retrocolic were don e in LGJ with no conversion to open surgery. Operating time (113.5+/-11.2 minutes versus 107.5+/-14.2 minutes), painkill er consumption (540+/-123.2 mg versus 430+/-58.2 mg) and post;operative hos pital stay (12.5+/-3.9 days versus 8.5+/-2.9 days) was report,ed respective ly. Serum WBC and cortisol levels were slightly increased in both groups during preoperative and postoperative day one and three. Serum ESR, TNF-alpha and IL-6 levels were significantly increased in OGJ groups. Postoperative comp lications (nine in OGJ, two in LGJ) and postoperative death (one in each gr oup) occurred. During the follow-up period (3 similar to 23 months), there was one case of readmission in each group due to anemia and generalized pai n.