| Abstract: |
Background: Palliative gastrojejunostomy(PG) is performed for symptom relief but robust data for efficacy are needed to assist in clinical decision-making and facilitate patient counseling. Delayed gastric emptying(DGE) is a common complication of PG that affects quality of life and is challenging to manage. Our objective was to investigate the effectiveness of PG using palliative outcomes and explore potential predictors of DGE after PG. Methods: A retrospective examination of a prospectively collected gastrojejunostomy database(2005–2022) at an academic center was performed. Demographics, palliative intent, and palliative outcomes such as symptom improvement and diet resumption were collected. Logistic regression was used to identify patient factors predicting DGE. Results: Of the 569 patients who underwent GJ, 397(69.8 %) had malignancy. Among them, 83 patients(20.9 %) underwent PG and 89.2 % reported symptom improvement, 95.2 % resumed PO intake at discharge, and had a median survival of 279 days(224−356), during which 70 % of patients did not experience GOO symptom recurrence. PG was associated with low reoperation rate(3.6 %) but high rate of postoperative DGE(20.5 %). Univariate and multivariate analysis identified maximum stomach area(MSA) > 100 cm2 on preoperative CT as an independent predictor of DGE (OR 4.36, 95 % CI 1.2–18.6, p = 0.031). Conclusions: PG is effective in symptom improvement and diet resumption with low reoperation and reasonable procedure-related complication rates. PG patients suffer a high rate of postoperative DGE for which MSA > 100 cm2 on preoperative CT was strongly associated with DGE. Preoperative MSA is a simple, practical, and clinically relevant tool to predict DGE and facilitate patient counseling and selection. Synopsis: Palliative gastrojejunostomy(PG) is performed in advanced cancer but has limited data supporting efficacy. We show PG improves symptoms but is associated with delayed gastric emptying(DGE). Maximum stomach area on preoperative CT predicts DGE and can facilitate patient selection and counseling. © 2025 Elsevier B.V., All rights reserved. |
