Association of preoperative symptoms of gastric outlet obstruction with delayed gastric emptying after pancreatoduodenectomy

Surgery ◽  
2013 ◽  
Vol 154 (3) ◽  
pp. 583-588 ◽  
Author(s):  
Jasper J. Atema ◽  
Wietse J. Eshuis ◽  
Olivier R.C. Busch ◽  
Thomas M. van Gulik ◽  
Dirk J. Gouma
Keyword(s):  
Gastric Emptying ◽  
Gastric Outlet Obstruction ◽  
Delayed Gastric Emptying ◽  
Outlet Obstruction

scholarly journals Gastroparesis in carcinoma gallbladder: a scintigraphic study

2018 ◽  
Vol 5 (6) ◽  
pp. 2086
Author(s):  
Pitchai Rajapandi ◽  
Adimoolam Eakanathan ◽  
Jeyaraj Ravishankar
Keyword(s):  
Gastric Emptying ◽  
Gastric Outlet Obstruction ◽  
Delayed Gastric Emptying ◽  
Outlet Obstruction ◽  
Solid Meal ◽  
Gastric Stasis ◽  
Carcinoma Gallbladder ◽  
Gastric Emptying Time ◽  
Scintigraphic Study ◽  
Emptying Time

Background: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical gastric outlet obstruction. There is strong association of gastroparesis with carcinoma gallbladder. The aim of the study was to find out the incidence of delayed gastric emptying in carcinoma gallbladder and its correlation with symptoms of stasis and stage of the disease.Methods: Patients diagnosed with carcinoma gallbladder and their matched controls were included in this study. Patients with mechanical gastric outlet obstruction were excluded. All patients underwent contrast enhanced computer tomography scan and radio labeled (Technitium 99) solid meal Scintigraphy study. Normal gastric emptying time was calculated from control group as Mean +2SD.Results: 30 patients were matched with 20 controls after obtaining informed consent. Upper limit of gastric emptying time is 55.09 minutes. Adenocarcinoma was the commonest histological subtype (50%), abdominal pain was the commonest symptom (86.7%) and hepatomegaly was the commonest sign (46.7%), GETt1/2 for patients was 66.72±26.52 minutes while it was 40.53±7.28 minutes in controls (p <0.05). Gastroparesis increased with advancing stage of carcinoma gallbladder (p <0.05). Symptoms of gastric stasis were seen only in 15.6% of patients.Conclusions: Patients with carcinoma gallbladder can have gastroparesis without obvious symptoms of delayed gastric emptying. This delay in gastric emptying can be documented reliably using solid meal scintigraphic study even in patients without symptoms of gastroparesis. The pathophysiology of gastroparesis needs further study. It may be prudent to remember that while performing palliative bypass surgery for gastric outflow obstruction, that in patients with carcinoma gallbladder, the gastrojejunostomy may not function as expected due to delayed gastric emptying.

scholarly journals PROFILE OF GASTRIC MALIGNANCIES PRESENTING AS GASTRIC OUTLET OBSTRUCTION – A ONE AND A HALF YEAR PROSPECTIVE STUDY FROM KASHMIR VALLEY

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Nisar Hussain Hamdani ◽  
Sumyra Khurshid Qadri ◽  
Zeeshan A Wani ◽  
Syed Asif A Shah ◽  
Sonaullah Kuchay
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Gastric Outlet Obstruction ◽  
Delayed Gastric Emptying ◽  
Outlet Obstruction ◽  
Pulmonary Complications ◽  
Common Symptom ◽  
Kashmir Valley ◽  
Medical College ◽  
Age Range

Background: Gastric adenocarcinoma is one of the frequent cancers seen in Kashmir valley. Patients often present with advanced disease and Gastric Outlet obstruction (GOO). We studied the profile and management of patients presenting with malignant GOO due to Gastric cancer at our center. Methods: A prospective one and half year study from May 2018 to Dec 2019 was done in the Department of Surgical Gastroenterology, Government Medical College, Srinagar. All adult patients with clinical and endoscopic evidence of malignant gastric outlet obstruction and features of gastric cancer were included. Results: Twenty three patients with GOO due to Gastric malignancies were noted in this period with a M:F ratio of 1.9:1 and age range of 32 to 79 years. Vomiting was the most common symptom present in 83 % patients followed by early satiety which was present in 74% of cases. Though patients gave history suggestive of weight loss but only 17 % patients had a documented weight loss. Palliative gastrojejunostomy was done in 21 patients and Radical Distal gastrectomy was done in 2 patients. Surgical site infection was the most common (06 cases; 26%) complication in our group followed by delayed gastric emptying (04 cases; 17.4%) and pulmonary complications (03 cases; 13%). Conclusion: Gastrojejunostomy offers good palliation of symptoms in patients with GOO due to GC. It can be offered with equally good results by laparoscopic access.

scholarly journals Gastric Outlet Obstruction in the Current Era–A Pictorial Review on Computed Tomography Imaging

2021 ◽  
Author(s):  
Ashita Rastogi ◽  
Somesh Singh ◽  
Rajanikant Yadav
Keyword(s):  
Computed Tomography ◽  
Gastric Emptying ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Motility Disorder ◽  
Computed Tomography Imaging ◽  
Motility Disorders ◽  
Tomography Imaging ◽  
Pictorial Review

AbstractGastric outlet obstruction is a pathophysiological entity characterized by mechanical impediment of gastric emptying, which may occur due to a variety of intrinsic or extrinsic causes affecting the antrum or pylorus or duodenum. The obstruction may be benign or malignant or secondary to a motility disorder. Imaging in gastric outlet obstruction identifies majority of these causes and may indirectly even point toward motility disorders. The advent of computed tomography imaging and its subsequent advances have allowed it to become the mainstay of evaluation of stomach, particularly in gastric outlet obstruction. In this pictorial review, a few causes of gastric outlet obstruction are exhibited.

Laparoscopic Gastrojejunostomy in Patients with Obstruction of the Gastric Outlet Secondary to Advanced Malignancies

2009 ◽  
Vol 75 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Eduardo A. Guzman ◽  
Andy Dagis ◽  
Lisa Bening ◽  
Alessio Pigazzi
Keyword(s):  
Gastric Outlet Obstruction ◽  
Surgical Outcomes ◽  
Delayed Gastric Emptying ◽  
Outlet Obstruction ◽  
Laparoscopic Group ◽  
Common Complication ◽  
Laparoscopic Gastrojejunostomy ◽  
Advanced Malignancies ◽  
Significant Difference ◽  
Detectable Difference

Surgical palliation is an important therapeutic goal in patients with gastric outlet obstruction from cancer. The use of laparoscopic approaches for this condition has not been well studied. Our objective is to compare surgical outcomes of laparoscopic and open gastrojejunostomies in patients with gastric outlet obstruction secondary to advanced malignancies. We did a retrospective review of 20 patients who underwent a palliative gastrojejunostomy as their primary surgical procedure. There were 10 patients in the laparoscopic group and 10 patients in the open one. We identified no significant difference between groups in mean surgery time (116 vs 116 minutes) ( P = 0.99), blood loss (23 vs 142 mL) ( P = 0.19), or length of stay (8 vs 14 days) ( P = 0.14). We also identified no difference in median time to tolerate a regular diet (7 vs 8 days) ( P = 0.49) and median survival (11.2 vs 9.0 months) ( P = 0.83). Delayed gastric emptying was the most common complication occurring in four patients. There is no detectable difference in surgical outcomes between laparoscopic and open gastrojejunostomies in the management of patients with obstruction of the gastric outlet secondary to cancer. Laparoscopic gastrojejunostomy is a safe and feasible operation in this setting

Gastric Outlet Obstruction Secondary to Pyloric Thickening in an Adolescent Male

2020 ◽  
Vol 36 (6) ◽  
pp. 585-592 ◽  
Author(s):  
Sonia Liddick
Keyword(s):  
Gastric Emptying ◽  
Gastric Outlet Obstruction ◽  
Crucial Role ◽  
Outlet Obstruction ◽  
Adolescent Male ◽  
Diagnostic Process ◽  
Rare Finding

Gastric outlet obstruction secondary to pyloric thickening in adolescents is an extremely rare finding. The condition is caused by a number of benign or malignant etiologies that cause an impediment to gastric emptying. Common and uncommon etiologies as well as the pathogenesis of gastric outlet obstruction are discussed. A case study of gastric outlet obstruction in a 14-year-old male is presented, and the crucial role of sonography in the diagnostic process of his condition is considered.

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