Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures

Background: Gastric outlet obstruction is a common condition due to various malignant and benign etiologies. Benign gastric outlet obstruction has been managed surgically by gastric resection or drainage procedures. Pyloroduodenojejunostomy (PDJ) is an old surgical procedure with very few descriptio...

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Main Authors: Shibumon Mundunadackal Madhavan, Smita Chauhan, Sneha Jha, Suneed Kumar, Shakeel Masood
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2022-01-01
Series:Formosan Journal of Surgery
Subjects:
Online Access:http://www.e-fjs.org/article.asp?issn=1682-606X;year=2022;volume=55;issue=1;spage=7;epage=15;aulast=Madhavan
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author Shibumon Mundunadackal Madhavan
Smita Chauhan
Sneha Jha
Suneed Kumar
Shakeel Masood
author_facet Shibumon Mundunadackal Madhavan
Smita Chauhan
Sneha Jha
Suneed Kumar
Shakeel Masood
author_sort Shibumon Mundunadackal Madhavan
collection DOAJ
description Background: Gastric outlet obstruction is a common condition due to various malignant and benign etiologies. Benign gastric outlet obstruction has been managed surgically by gastric resection or drainage procedures. Pyloroduodenojejunostomy (PDJ) is an old surgical procedure with very few descriptions in the literature and is rarely performed now. We present our experience of six cases of Roux-en-Y PDJ performed for benign gastroduodenal strictures causing gastric outlet obstruction. Materials and Methods: Prospective study of patients who underwent Roux-en-Y PDJ for benign gastroduodenal obstruction in the department of Surgical Gastroenterology in a teaching hospital in Northern India from January 2017 to December 2019. Side-to-side pyloroduodenojejunostomy was done with a Roux-en-Y limb of jejunum along with side-to-side jejunojejunostomy. A feeding jejunostomy was added in patients who were nutritionally poor. No vagotomy was performed. Results: Four male and two female patients with median (range) age of 42 (37–61) years underwent PDJ. There were no major postoperative complications in the study group. Etiology of benign strictures was tuberculosis in two patients and peptic in four. On mean (standard deviation [SD]) follow-up of 19.5 (5.12) months, all the patients were symptom-free. The mean (SD) weight gain was 10 (3.40) kg. Conclusion: Roux-en-Y PDJ is a useful alternative in the management of surgically difficult cases of benign gastroduodenal strictures with low morbidity and good outcome.
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spelling doaj.art-d674f16b26aa4f689d356a250f71391b2023-08-02T06:29:55ZengWolters Kluwer Health/LWWFormosan Journal of Surgery1682-606X2022-01-0155171510.4103/fjs.fjs_33_21Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal stricturesShibumon Mundunadackal MadhavanSmita ChauhanSneha JhaSuneed KumarShakeel MasoodBackground: Gastric outlet obstruction is a common condition due to various malignant and benign etiologies. Benign gastric outlet obstruction has been managed surgically by gastric resection or drainage procedures. Pyloroduodenojejunostomy (PDJ) is an old surgical procedure with very few descriptions in the literature and is rarely performed now. We present our experience of six cases of Roux-en-Y PDJ performed for benign gastroduodenal strictures causing gastric outlet obstruction. Materials and Methods: Prospective study of patients who underwent Roux-en-Y PDJ for benign gastroduodenal obstruction in the department of Surgical Gastroenterology in a teaching hospital in Northern India from January 2017 to December 2019. Side-to-side pyloroduodenojejunostomy was done with a Roux-en-Y limb of jejunum along with side-to-side jejunojejunostomy. A feeding jejunostomy was added in patients who were nutritionally poor. No vagotomy was performed. Results: Four male and two female patients with median (range) age of 42 (37–61) years underwent PDJ. There were no major postoperative complications in the study group. Etiology of benign strictures was tuberculosis in two patients and peptic in four. On mean (standard deviation [SD]) follow-up of 19.5 (5.12) months, all the patients were symptom-free. The mean (SD) weight gain was 10 (3.40) kg. Conclusion: Roux-en-Y PDJ is a useful alternative in the management of surgically difficult cases of benign gastroduodenal strictures with low morbidity and good outcome.http://www.e-fjs.org/article.asp?issn=1682-606X;year=2022;volume=55;issue=1;spage=7;epage=15;aulast=Madhavangastric outlet obstructiongastroduodenal stricturepeptic stricturepyloroduodenojejunostomy
spellingShingle Shibumon Mundunadackal Madhavan
Smita Chauhan
Sneha Jha
Suneed Kumar
Shakeel Masood
Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
Formosan Journal of Surgery
gastric outlet obstruction
gastroduodenal stricture
peptic stricture
pyloroduodenojejunostomy
title Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
title_full Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
title_fullStr Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
title_full_unstemmed Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
title_short Pyloroduodenojejunostomy: A useful alternative for benign gastroduodenal strictures
title_sort pyloroduodenojejunostomy a useful alternative for benign gastroduodenal strictures
topic gastric outlet obstruction
gastroduodenal stricture
peptic stricture
pyloroduodenojejunostomy
url http://www.e-fjs.org/article.asp?issn=1682-606X;year=2022;volume=55;issue=1;spage=7;epage=15;aulast=Madhavan
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AT smitachauhan pyloroduodenojejunostomyausefulalternativeforbenigngastroduodenalstrictures
AT snehajha pyloroduodenojejunostomyausefulalternativeforbenigngastroduodenalstrictures
AT suneedkumar pyloroduodenojejunostomyausefulalternativeforbenigngastroduodenalstrictures
AT shakeelmasood pyloroduodenojejunostomyausefulalternativeforbenigngastroduodenalstrictures