A systematic review and meta-analysis comparing partial stomach partitioning gastrojejunostomy versus conventional gastrojejunostomy for malignant gastroduodenal obstruction

Purpose Partial stomach partitioning gastrojejunostomy (PSPGJ) was introduced as a palliative treatment for malignant gastric outlet obstruction (MGO) caused by unresectable gastric or periampullary cancers and suggested to offer advantages over conventional gastrojejunostomy (CGJ) in reducing the r...

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Bibliographic Details
Published in:Langenbeck's archives of surgery 2016-09, Vol.401 (6), p.777-785
Main Authors: Kumagai, Koshi, Rouvelas, Ioannis, Ernberg, Annika, Persson, Saga, Analatos, Apostolos, Mariosa, Daniela, Lindblad, Mats, Nilsson, Magnus, Ye, Weimin, Lundell, Lars, Tsai, Jon A.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
Gastric Bypass - adverse effects
Gastric Bypass - methods
Gastric Emptying
Gastric Outlet Obstruction - etiology
Gastric Outlet Obstruction - pathology
Gastric Outlet Obstruction - surgery
General Surgery
Humans
Medicin och hälsovetenskap
Medicine
Medicine & Public Health
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Systematic Reviews and Meta-analyses
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
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Summary:Purpose Partial stomach partitioning gastrojejunostomy (PSPGJ) was introduced as a palliative treatment for malignant gastric outlet obstruction (MGO) caused by unresectable gastric or periampullary cancers and suggested to offer advantages over conventional gastrojejunostomy (CGJ) in reducing the risk for delayed gastric emptying (DGE). However, insufficient evidence is available to allow a comprehensive view of the true value of PSPGJ. The present study aimed to show the advantages of PSPGJ in terms of alleviating DGE and improving postoperative recovery compared to CGJ. Methods A systematic literature search was performed, and studies comparing DGE and other perioperative and postoperative data including operation time, blood loss, total postoperative complications, anastomotic leak, postoperative period before oral intake, and/or hospital stay between PSPGJ and CGJ for MGO were incorporated. Risk ratio (RR) for binary variables and weighted mean difference (WMD) for continuous variables were calculated, and meta-analyses were performed. Results Seven studies containing 207 patients were included. The risk for DGE was significantly lower after PSPGJ (RR 0.32; 95%CI 0.17 to 0.60; P  
ISSN:1435-2443
1435-2451
1435-2451
DOI:10.1007/s00423-016-1470-8