Keywords : gastric outlet obstruction scoring system


Managements of Patients with Malignant Gastric Outlet Obstruction: Prospective Study

Laith. R. Alhadad; Ali Hussein Jasim; Wail Sabah Al-Saffar

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 1, Pages 45-52

ABSTRACT :
BACKGROUND:
Gastric outlet obstruction is the clinical and pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. It classified into benign and malignant group. Distal gastric cancer form 35% of cases with malignant gastric outlet obstruction.
OBJECTIVE :
To study the causes of malignant gastric obstruction and how to treat them, in addition the application of gastric outlet obstruction score in our patient pre- and post-treatment.
PATIENT AND METHODS:
Between January-2012 to January-2014, a prospective study involves all patients with malignant gastric outlet obstruction in the surgical department in the gastrointestinal and Hepatology teaching hospital.
RESULTS:
A total of 51 cases of malignant gastric outlet obstruction were enrolled in the research, with mean age 53.21 ±14.6 years. There were 30 male patients (58.8%) with male to female ratio = 1.4:1. Non-bilious vomiting was present in (100%) of cases. antropyloric region was found in (47.1%) patients. Regarding GOOS, there were improvement in all patients (p value =0.048). Distal gastrectomy done in 19.6% of patients and gastrojujenostomy performed in 80.3% of patients. Gastric adenocarcinoma found in 15.7%, in 47.05% of patients was found to have metastatic adenocarcinoma.
CONCLUSION:
Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons. In recent years malignant cause become more. Gastric outlet obstruction score has a role in management of patients. Distal gastrectomy is the treatment of choice in resectable cases, while gastrojujenostomy can be used in advanced cases.