Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction

Surg Endosc. 2006 Feb;20(2):239-42. doi: 10.1007/s00464-005-0130-9. Epub 2005 Dec 9.


Background: We prospectively compared laparoscopic gastrojejunostomy with duodenal stenting as a means of palliating malignant gastric outflow obstruction.

Methods: A total of 27 patients with malignant gastric outflow obstruction were randomized to either laparoscopic gastrojejunostomy (LGJ) or duodenal stenting (DS) over a 3-year period.

Results: Thirteen patients underwent successful LGJ and 10 had successful DS. Eight patients had complications after LGJ, but none had complications after DS. Patients who underwent LGJ had a significant increase in visual analog pain score at day 1 (p = 0.05), and also had a longer hospital stay compared to those who underwent DS (11.4 vs. 5.2 days, p = 0.02). After DS, patients experienced an improvement in physical health at 1 month as measured using the Short Form-36 (SF-36) questionnaire (p < 0.01). There was no change following LGJ.

Conclusion: Duodenal stenting is a safe means of palliating malignant gastric outflow obstruction. It offers significant advantages for patients compared with minimal-access surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Duodenum*
  • Female
  • Gastric Outlet Obstruction / etiology*
  • Gastric Outlet Obstruction / therapy*
  • Gastroenterostomy* / adverse effects
  • Humans
  • Jejunostomy* / adverse effects
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Outcome Assessment, Health Care / methods
  • Pain, Postoperative / physiopathology
  • Prospective Studies
  • Quality of Life
  • Stents* / adverse effects
  • Surveys and Questionnaires
  • Survival Analysis