Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature
| Autor: | Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Roberto de la Plaza-Llamas, José Manuel Ramia, A. Lopez-Marcano |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Gastric bypass medicine.medical_treatment 030230 surgery 03 medical and health sciences 0302 clinical medicine Quality of life Stomach Neoplasms medicine Humans In patient Laparoscopy Gastroenterosmy medicine.diagnostic_test Gastric Outlet Obstruction business.industry Patient Selection General surgery Palliative Care Gastroenterology Stent Cancer Minireviews Gastric outlet obstruction General Medicine Evidence-based medicine Sytematic review medicine.disease Pancreatic Neoplasms Jaundice Obstructive Biliary Tract Neoplasms Treatment Outcome Duodenal obstruction Quality of Life Stents 030211 gastroenterology & hepatology Gastrojejunostomy business |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| DOI: | 10.3748/wjg.v24.i18.1978 |
| Popis: | The major symptoms of advanced hepatopancreatic-biliary cancer are biliary obstruction, pain and gastric outlet obstruction (GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach. We performed a systematic review of the literature, according PRISMA guidelines, to search for articles on laparoscopic gastrojejunostomy for malignant GOO treatment. We also report our personal series, from 2009 to 2017. A review of the literature suggests that there is no standardized surgical technique either standardized outcomes to report. Most of the studies are case series, so level of evidence is low. Decision-making must consider medical condition, nutritional status, quality of life and life expectancy. Evaluation of the patient and multidisciplinary expertise are required to select appropriate approach. Given the limited studies and the difficulty to perform prospective controlled trials, no study can answer all the complexities of malignant GOO and more outcome data is needed. |
| Databáze: | OpenAIRE |
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