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Common Problems in Acute Care Surgery pp 227–248Cite as

Gastric Outlet Obstruction

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Abstract

Gastric outlet obstruction (GOO) indicates obstruction of the distal stomach, pylorus, or proximal duodenum. The term is also used to encompass lesions in the second through fourth portion of the duodenum as the demarcation between gastric outlet obstruction and duodenal obstruction is inconsistent [1]. GOO can be the result of benign or malignant conditions. While classically GOO was ascribed to noncancerous pathology, a frequently cited review by Johnson et al. of 261 patients with GOO indicated that the epidemiology of GOO is changing [2]. They noted that between 1962 and 1975, malignancy accounted for 33 % of GOO cases at their hospital in the United Kingdom. Between 1976 and 1985 malignancy accounted for 50 % of cases. However, from 1987 to 1988 malignancy was responsible for 66 % of cases of GOO. Current thinking is that GOO in adults is secondary to malignancy unless proven otherwise.

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References

  1. Kim ID, Kang DH, Choi CW, et al. Prevention of covered enteral stent migration in patients with malignant gastric outlet obstruction: a pilot study of anchoring with endoscopic clips. Scand J Gastroenterol. 2010;45(1):100–5.

    Article  PubMed  Google Scholar 

  2. Johnson CD, Ellis H. Gastric outlet obstruction now predicts malignancy. Br J Surg. 1990;77(9):1023–4.

    Article  PubMed  CAS  Google Scholar 

  3. Mäkelä JT, Kiviniemi H, Laitinen S. Gastric outlet obstruction caused by peptic ulcer disease analysis of 99 patients. Hepatogastroenterology. 1996;43(9):547–52.

    PubMed  Google Scholar 

  4. Gibson JB, Behrman SW, Fabian TC, Britt LG. Gastric outlet obstruction resulting from peptic ulcer disease requiring surgical intervention is infrequently associated with Helicobacter pylori infection. J Am Coll Surg. 2000;191(1):32–7.

    Article  PubMed  CAS  Google Scholar 

  5. Barksdale AR, Schwartz RW. The evolving management of gastric outlet obstruction from peptic ulcer disease. Curr Surg. 2002;59(4):404–9.

    Article  PubMed  Google Scholar 

  6. Millat B, Fingerhut A, Borie F. Surgical treatment of complicated duodenal ulcers: controlled trials. World J Surg. 2000;24(3):299–306.

    Article  PubMed  CAS  Google Scholar 

  7. Piñero Madrona A, Robles R, López J, et al. Evolution of the need for operation for peptic pyloric stenosis over a period of 24 years (1976–1999). Eur J Surg. 2001;167(10):758–60.

    Article  PubMed  Google Scholar 

  8. Shabbir J, Durrani S, Ridgway PF, Mealy K. Proton pump inhibition is a feasible primary alternative to surgery and balloon dilatation in adult peptic pyloric stenosis (APS): report of six consecutive cases. Ann R Coll Surg Engl. 2006;88(2):174–5.

    Article  PubMed  CAS  Google Scholar 

  9. Ferzoco S, Soybel D. Gastric outlet obstruction, peforation, and other complications of gastroduodenal ulcer. In: Wolfe M, editor. Therapy of digestive disorders. 2nd ed. Philadelphia, PA: Saunders; 2006. p. 357–72.

    Chapter  Google Scholar 

  10. Berg D, Dempsey DT. Peptic ulcer disease: obstruction. In: Bland K, editor. General surgery principles and international practice. New York: Springer; 2009. p. 525–32.

    Google Scholar 

  11. Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140(2):201–8.

    Article  PubMed  Google Scholar 

  12. Richard K. Gastrointestinal dilation. In: Yamada T, Alpers D, Owyang C, editors. Textbook of gastroenterology. Philadelphia: Lippincott; 1990. p. 2039–54.

    Google Scholar 

  13. Helmer K, Mercer D. Gastric physiology and acid-peptic disorders. In: Miller T, editor. Modern surgical care. 3rd ed. New York: Informa; 2006. p. 333–67.

    Google Scholar 

  14. Adler DG. Enteral stents for malignant gastric outlet obstruction: testing our mettle. Gastrointest Endosc. 2007;66(2):361–3.

    Article  PubMed  Google Scholar 

  15. Mohammed AA, Benmousa A, Almeghaiseeb I, Alkarawi M. Gastric outlet obstruction. Hepatogastroenterology. 2007;54(80):2415–20.

    PubMed  Google Scholar 

  16. Ellis H. Pyloric stenosis complicating duodenal ulceration. World J Surg. 1987;11(3):315–8.

    Article  PubMed  CAS  Google Scholar 

  17. Gaughan C, Dempsey DT. Management of duodenal ulcer. In: Cameron J, Cameron A, editors. Current surgical therapy. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 68–73.

    Chapter  Google Scholar 

  18. Mabogunje OA, Lawrie JH. Surgical management of duodenal ulcer in Zaria, Nigeria. J R Coll Surg Edinb. 1985;30(5):283–7.

    PubMed  CAS  Google Scholar 

  19. Cherian PT, Cherian S, Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy. Gastrointest Endosc. 2007;66(3):491–7.

    Article  PubMed  Google Scholar 

  20. Kuwada SK, Alexander GL. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis. Gastrointest Endosc. 1995;41(1):15–7.

    Article  PubMed  CAS  Google Scholar 

  21. Lam YH, Lau JY, Fung TM, et al. Endoscopic balloon dilation for benign gastric outlet obstruction with or without Helicobacter pylori infection. Gastrointest Endosc. 2004;60(2):229–33.

    Article  Google Scholar 

  22. Abdel-Salam WN, Katri KM, Bessa SS, El-Kayal E-SA. Laparoscopic-assisted truncal vagotomy and gastro-jejunostomy: trial of simplification. J Laparoendosc Adv Surg Tech A. 2009;19(2):125–7.

    Article  PubMed  Google Scholar 

  23. Pollard SG, Friend PJ, Dunn DC, Hunter JO. Highly selective vagotomy with duodenal dilatation in patients with duodenal ulceration and gastric outlet obstruction. Br J Surg. 1990;77(12):1365–6.

    Article  PubMed  CAS  Google Scholar 

  24. Goldstein H, Boyle JD. The saline load test–a bedside evaluation of gastric retention. Gastroenterology. 1965;49(4):375–80.

    PubMed  CAS  Google Scholar 

  25. Griffith GH, Owen GM, Kirkman S, Shields R. Measurement of rate of gastric emptying using chromium-51. Lancet. 1966;1(7449):1244–5.

    Article  PubMed  CAS  Google Scholar 

  26. Maetani I, Ukita T, Tada T, et al. Gastric emptying in patients with palliative stenting for malignant gastric outlet obstruction. Hepatogastroenterology. 2008;55(81):298–302.

    PubMed  Google Scholar 

  27. Matolo NM, Stadalnik RC. Assessment of gastric motility using meal labeled with technetium-99m sulfur colloid. Am J Surg. 1983;146(6):823–6.

    Article  PubMed  CAS  Google Scholar 

  28. Yusuf TE, Brugge WR. Endoscopic therapy of benign pyloric stenosis and gastric outlet obstruction. Curr Opin Gastroenterol. 2006;22(5):570–3.

    Article  PubMed  Google Scholar 

  29. Awan A, Johnston DE, Jamal MM. Gastric outlet obstruction with benign endoscopic biopsy should be further explored for malignancy. Gastrointest Endosc. 1988;48(5):497–500.

    Article  Google Scholar 

  30. Newman N, Mufeed S, Makary M. Benign gastric ulcer. In: Cameron J, Cameron A, editors. Current surgical therapy. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 63–8.

    Chapter  Google Scholar 

  31. Choudhary AM, Roberts I, Nagar A, Tabrez S, Gupta T. Helicobacter pylori-related gastric outlet obstruction: is there a role for medical treatment? J Clin Gastroenterol. 2001;32(3):272–3.

    Article  PubMed  CAS  Google Scholar 

  32. Dempsey DT. Management of benign gastric outlet obstruction in the adult patient. Curr Surg. 2002;59(2):158–62.

    Article  PubMed  Google Scholar 

  33. Kochhar R, Poornachandra KS, Dutta U, Agrawal A, Singh K. Early endoscopic balloon dilation in caustic-induced gastric injury. Gastrointest Endosc. 2010;71(4):737–44.

    Article  PubMed  Google Scholar 

  34. Boylan JJ, Gradzka MI. Long-term results of endoscopic balloon dilatation for gastric outlet obstruction. Dig Dis Sci. 1999;44(9):1883–6.

    Article  PubMed  CAS  Google Scholar 

  35. Kovacs T, Jensen D. Complications of peptic ulcer disease. In: DiMarino A, Benjamin SB, editors. Gastrointestinal disease: an endoscopic approach. 2nd ed. Thorofare, NJ: Slack; 2002. p. 411–38.

    Google Scholar 

  36. Artifon ELA, Sakai P, Hondo FY, et al. An evaluation of gastric scintigraphy pre- and postpyloroduodenal peptic stenosis dilation. Surg Endosc. 2006;20(2):243–8.

    Article  PubMed  CAS  Google Scholar 

  37. Harrell AG, Sing RF, Novitsky YW, et al. A re-evaluation of vagotomy and gastrojejunostomy for benign gastric outlet obstruction. J Laparoendosc Adv Surg Tech A. 2006;16(1):77–8. author reply 78.

    Article  PubMed  CAS  Google Scholar 

  38. Broderick T, Matthews J. Ulcer complications. In: Zinner M, Ashley S, editors. Maingot’s abdominal operations. 11th ed. New York: McGraw-Hill Medical; 2007. p. 353–77.

    Google Scholar 

  39. Siu WT, Tang CN, Law BKB, et al. Vagotomy and gastrojejunostomy for benign gastric outlet obstruction. J Laparoendosc Adv Surg Tech A. 2004;14(5):266–9.

    Article  PubMed  Google Scholar 

  40. Csendes A, Burgos AM, Smok G, et al. Latest results (12–21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers. Ann Surg. 2009;249(2):189–94.

    Article  PubMed  Google Scholar 

  41. Csendes A, Maluenda F, Braghetto I, et al. Prospective randomized study comparing three surgical techniques for the treatment of gastric outlet obstruction secondary to duodenal ulcer. Am J Surg. 1993;166(1):45–9.

    Article  PubMed  CAS  Google Scholar 

  42. Kim S-M, Song J, Oh SJ, et al. Comparison of laparoscopic truncal vagotomy with gastrojejunostomy and open surgery in peptic pyloric stenosis. Surg Endosc. 2009;23(6):1326–30.

    Article  PubMed  Google Scholar 

  43. Wyman A, Stuart RC, Ng EK, Chung SC, Li AK. Laparoscopic truncal vagotomy and gastroenterostomy for pyloric stenosis. Am J Surg. 1996;171(6):600–3.

    Article  PubMed  CAS  Google Scholar 

  44. Saccomani GE, Percivale A, Stella M, Durante V, Pellicci R. Laparoscopic billroth II gastrectomy for completely stricturing duodenal ulcer: technical details. Scand J Surg. 2003;92(3):200–2.

    PubMed  CAS  Google Scholar 

  45. Rangarajan M, Subramanian CS, Chandralathan TA. Laparoscopy-assisted truncal vagotomy with antecolic posterior gastrojejunostomy for benign gastric outlet obstruction. Surg Endosc. 2006;20(1):61–3.

    Article  PubMed  CAS  Google Scholar 

  46. Kelly K, Teotia S. Proximal gastric vagotomy. In: Fischer J, editor. Mastery of surgery. 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2007. p. 872–7.

    Google Scholar 

  47. Mills GH, Jones RB. Explosion during surgery for gastric outlet obstruction. Anaesthesia. 1993;48(6):544.

    Article  PubMed  CAS  Google Scholar 

  48. Søreide K, Sarr MG, Søreide JA. Pyloroplasty for benign gastric outlet obstruction–indications and techniques. Scand J Surg. 2006;95(1):11–6.

    PubMed  Google Scholar 

  49. Maull KI, Price DC. Migratory gallstone causing duodenal obstruction. J Am Coll Surg. 2006;203(5):781.

    Article  PubMed  Google Scholar 

  50. Rodriguez Romano D, Moreno Gonzalez E, Jiménez Romero C, et al. Duodenal obstruction by gallstones (Bouveret’s syndrome). Presentation of a new case and literature review. Hepatogastroenterology. 1997;44(17):1351–5.

    PubMed  CAS  Google Scholar 

  51. Yamamoto T, Allan RN, Keighley MR. An audit of gastroduodenal Crohn disease: clinicopathologic features and management. Scand J Gastroenterol. 1999;34(10):1019–24.

    Article  PubMed  CAS  Google Scholar 

  52. Go MR, Muscarella 2nd P, Needleman BJ, Cook CH, Melvin WS. Endoscopic management of stomal stenosis after Roux-en-Y gastric bypass. Surg Endosc. 2004;18(1):56–9.

    Article  PubMed  CAS  Google Scholar 

  53. Vance PL, de Lange EE, Shaffer Jr HA, Schirmer B. Gastric outlet obstruction following surgery for morbid obesity: efficacy of fluoroscopically guided balloon dilation. Radiology. 2002;222(1):70–2.

    Article  PubMed  Google Scholar 

  54. Peifer KJ, Shiels AJ, Azar R, et al. Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass. Gastrointest Endosc. 2007;66(2):248–52.

    Article  PubMed  Google Scholar 

  55. Ahmad J, Martin J, Ikramuddin S, Schauer P, Slivka A. Endoscopic balloon dilation of gastroenteric anastomotic stricture after laparoscopic gastric bypass. Endoscopy. 2003;35(9):725–8.

    Article  PubMed  CAS  Google Scholar 

  56. Rao YG, Pande GK, Sahni P, Chattopadhyay TK. Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature. Can J Surg. 2004;47(5):364–8.

    PubMed  Google Scholar 

  57. Yau KK, Siu WT, Cheung HYS, Yang GPC, Li MK. Acute gastric volvulus: an unusual cause of gastric outlet obstruction. Minim Invasive Ther Allied Technol. 2005;14(1):2–5.

    Article  PubMed  CAS  Google Scholar 

  58. Deitch JS, Heller JA, McGagh D, et al. Abdominal aortic aneurysm causing duodenal obstruction: two case reports and review of the literature. J Vasc Surg. 2004;40(3):543–7.

    Article  PubMed  Google Scholar 

  59. O’Carroll R, Kennedy R. Gastric outlet obstruction. Can J Surg. 2007;50(6):E29–30.

    PubMed  Google Scholar 

  60. Kochhar R, Dutta U, Sethy PK, et al. Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction. Gastrointest Endosc. 2009;69(4):800–5.

    Article  PubMed  Google Scholar 

  61. Savas J, Miller T, Mercer D. Derangements in gastrointestinal function secondary to previous surgery. In: Miller T, editor. Modern surgical care: physiologic foundations and clinical applications. 3rd ed. New York: Informa Healthcare; 2006.

    Google Scholar 

  62. Madriaga M, Soybel D. Motility disorders of the stomach and small bowel. In: Cameron J, Cameron A, editors. Current surgical therapy. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 117–24.

    Chapter  Google Scholar 

  63. Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS. Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers. Am J Gastroenterol. 1995;90(10):1769–70.

    PubMed  CAS  Google Scholar 

  64. Khullar SK, DiSario JA. Gastric outlet obstruction. Gastrointest Endosc Clin N Am. 1996;6(3):585–603.

    PubMed  CAS  Google Scholar 

  65. Misra SP, Dwivedi M, Misra V. Malignancy is the most common cause of gastric outlet obstruction even in a developing country. Endoscopy. 1998;30(5):484–6.

    Article  PubMed  CAS  Google Scholar 

  66. Al-Rashedy M, Dadibhai M, Shareif A, et al. Laparoscopic gastric bypass for gastric outlet obstruction is associated with smoother, faster recovery and shorter hospital stay compared with open surgery. J Hepatobiliary Pancreat Surg. 2005;12(6):474–8.

    Article  PubMed  Google Scholar 

  67. Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97(1):72–8.

    Article  PubMed  Google Scholar 

  68. Lillemoe KD, Cameron JL, Hardacre JM, et al. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial. Ann Surg. 1999;230(3):322–8. discussion 328–330.

    Article  PubMed  CAS  Google Scholar 

  69. Choi Y-B. Laparoscopic gatrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer. Surg Endosc. 2002;16(11):1620–6.

    Article  PubMed  Google Scholar 

  70. Del Piano M, Ballarè M, Montino F, et al. Endoscopy or surgery for malignant GI outlet obstruction? Gastrointest Endosc. 2005;61(3):421–6.

    Article  PubMed  Google Scholar 

  71. Medina-Franco H, Abarca-Pérez L, España-Gómez N, et al. Morbidity-associated factors after gastrojejunostomy for malignant gastric outlet obstruction. Am Surg. 2007;73(9):871–5.

    PubMed  Google Scholar 

  72. Bergamaschi R, Arnaud JP, Mårvik R, Myrvold HE. Laparoscopic antiperistaltic versus isoperistaltic gastrojejunostomy for palliation of gastric outlet obstruction in advanced cancer. Surg Laparosc Endosc Percutan Tech. 2002;12(6):393–7.

    Article  PubMed  CAS  Google Scholar 

  73. House MG, Choti MA. Palliative therapy for pancreatic/biliary cancer. Surg Clin North Am. 2005;85(2):359–71.

    Article  PubMed  Google Scholar 

  74. Maetani I, Isayama H, Mizumoto Y. Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study. Gastrointest Endosc. 2007;66(2):355–60.

    Article  PubMed  Google Scholar 

  75. Hosono S, Ohtani H, Arimoto Y, Kanamiya Y. Endoscopic stenting versus surgical gastroenterostomy for palliation of malignant gastroduodenal obstruction: a meta-analysis. J Gastroenterol. 2007;42(4):283–90.

    Article  PubMed  Google Scholar 

  76. Siddiqui A, Spechler SJ, Huerta S. Surgical bypass versus endoscopic stenting for malignant gastroduodenal obstruction: a decision analysis. Dig Dis Sci. 2007;52(1):276–81.

    Article  PubMed  Google Scholar 

  77. Piesman M, Kozarek RA, Brandabur JJ, et al. Improved oral intake after palliative duodenal stenting for malignant obstruction: a prospective multicenter clinical trial. Am J Gastroenterol. 2009;104(10):2404–11.

    Article  PubMed  Google Scholar 

  78. Song H-Y, Shin JH, Yoon CJ, et al. A dual expandable nitinol stent: experience in 102 patients with malignant gastroduodenal strictures. J Vasc Interv Radiol. 2004;15(12):1443–9.

    Article  PubMed  Google Scholar 

  79. Lowe AS, Beckett CG, Jowett S, et al. Self-expandable metal stent placement for the palliation of malignant gastroduodenal obstruction: experience in a large, single, UK centre. Clin Radiol. 2007;62(8):738–44.

    Article  PubMed  CAS  Google Scholar 

  80. Larssen L, Medhus AW, Hauge T. Treatment of malignant gastric outlet obstruction with stents: an evaluation of the reported variables for clinical outcome. BMC Gastroenterol. 2009;9:45.

    Article  PubMed  Google Scholar 

  81. Watanabe A, Maehara Y, Okuyama T, et al. Gastric carcinoma with pyloric stenosis. Surgery. 1998;123(3):330–4.

    Article  PubMed  CAS  Google Scholar 

  82. Schmidt C, Gerdes H, Hawkins W, et al. A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction. Am J Surg. 2009;198(1):92–9.

    Article  PubMed  Google Scholar 

  83. Maetani I, Akatsuka S, Ikeda M, et al. Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol. 2005;40(10):932–7.

    Article  PubMed  CAS  Google Scholar 

  84. Gaidos JKJ, Draganov PV. Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents. World J Gastroenterol. 2009;15(35):4365–71.

    Article  PubMed  Google Scholar 

  85. Baron TH, Harewood GC. Enteral self-expandable stents. Gastrointest Endosc. 2003;58(3):421–33.

    Article  PubMed  Google Scholar 

  86. Kim CG, Choi IJ, Lee JY, et al. Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study. Gastrointest Endosc. 2010;72(1):25–32.

    Article  PubMed  Google Scholar 

  87. Jeurnink SM, van Eijck CHJ, Steyerberg EW, Kuipers EJ, Siersema PD. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18.

    Article  PubMed  Google Scholar 

  88. Singer SB, Asch M. Metallic stents in the treatment of duodenal obstruction: technical issues and results. Can Assoc Radiol J. 2000;51(2):121–9.

    PubMed  CAS  Google Scholar 

  89. Aviv RI, Shyamalan G, Khan FH, et al. Use of stents in the palliative treatment of malignant gastric outlet and duodenal obstruction. Clin Radiol. 2002;57(7):587–92.

    Article  PubMed  CAS  Google Scholar 

  90. Shaw JM, Bornman PC, Krige JEJ, Stupart DA, Panieri E. Self-expanding metal stents as an alternative to surgical bypass for malignant gastric outlet obstruction. Br J Surg. 2010;97(6):872–6.

    Article  PubMed  CAS  Google Scholar 

  91. Cho YK, Kim SW, Hur WH, et al. Clinical outcomes of self-expandable metal stent and prognostic factors for stent patency in gastric outlet obstruction caused by gastric cancer. Dig Dis Sci. 2010;55(3):668–74.

    Article  PubMed  CAS  Google Scholar 

  92. Dormann A, Meisner S, Verin N, Wenk Lang A. Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy. 2004;36(6):543–50.

    Article  PubMed  CAS  Google Scholar 

  93. Stupart DA, Panieri E, Dent DM. Gastrojejunostomy for gastric outlet obstruction in patients with gastric carcinoma. S Afr J Surg. 2006;44(2):52–4.

    PubMed  CAS  Google Scholar 

  94. McFadden D, Schneider J. Gastric adenocarcinoma. In: Cameron J, Cameron A, editors. Current surgical therapy. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 80–5.

    Chapter  Google Scholar 

  95. Watanapa P, Williamson RC. Surgical palliation for pancreatic cancer: developments during the past two decades. Br J Surg. 1992;79(1):8–20.

    Article  PubMed  CAS  Google Scholar 

  96. Guzman EA, Dagis A, Bening L, Pigazzi A. Laparoscopic gastrojejunostomy in patients with obstruction of the gastric outlet secondary to advanced malignancies. Am Surg. 2009;75(2):129–32.

    PubMed  Google Scholar 

  97. Nagy A, Brosseuk D, Hemming A, Scudamore C, Mamazza J. Laparoscopic gastroenterostomy for duodenal obstruction. Am J Surg. 1995;169(5):539–42.

    Article  PubMed  CAS  Google Scholar 

  98. Ghanem AM, Hamade AM, Sheen AJ, et al. Laparoscopic gastric and biliary bypass: a single-center cohort prospective study. J Laparoendosc Adv Surg Tech A. 2006;16(1):21–6.

    Article  PubMed  Google Scholar 

  99. Gentileschi P, Kini S, Gagner M. Palliative laparoscopic hepatico- and gastrojejunostomy for advanced pancreatic cancer. JSLS. 2002;6(4):331–8.

    PubMed  Google Scholar 

  100. Kazanjian KK, Reber HA, Hines OJ. Laparoscopic gastrojejunostomy for gastric outlet obstruction in pancreatic cancer. Am Surg. 2004;70(10):910–3.

    PubMed  Google Scholar 

  101. Alam TA, Baines M, Parker MC. The management of gastric outlet obstruction secondary to inoperable cancer. Surg Endosc. 2003;17(2):320–3.

    Article  PubMed  CAS  Google Scholar 

  102. Lillemoe KD, Sauter PK, Pitt HA, Yeo CJ, Cameron JL. Current status of surgical palliation of periampullary carcinoma. Surg Gynecol Obstet. 1993;176(1):1–10.

    PubMed  CAS  Google Scholar 

  103. Fiori E, Lamazza A, Volpino P, et al. Palliative management of malignant antro-pyloric strictures. Gastroenterostomy versus endoscopic stenting. A randomized prospective trial. Anticancer Res. 2004;24(1):269–71.

    PubMed  Google Scholar 

  104. Johnsson E, Thune A, Liedman B. Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting: clinical outcome and health economic evaluation. World J Surg. 2004;28(8):812–7.

    Article  PubMed  Google Scholar 

  105. Espinel J, Sanz O, Vivas S, et al. Malignant gastrointestinal obstruction: endoscopic stenting versus surgical palliation. Surg Endosc. 2006;20(7):1083–7.

    Article  PubMed  CAS  Google Scholar 

  106. Jeurnink SM, Steyerberg EW, van Hooft JE, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc. 2010;71(3):490–9.

    Article  PubMed  Google Scholar 

  107. Ly J, O’Grady G, Mittal A, Plank L, Windsor JA. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc. 2010;24(2):290–7.

    Article  PubMed  Google Scholar 

  108. Skandalakis L, Gray S, Skandalakis J. The history and surgical anatomy of the vagus nerve. Surg Gynecol Obstet. 1986;162:83.

    Google Scholar 

  109. Diesen D, Haney J, Pappas J. Laparoscopic management of peptic ulcer disease. In: Pappas T, Pryor A, Harnisch M, editors. Atlas of laparoscopic surgery. 3rd ed. New York: Current Medicine; 2008. p. 65–79.

    Google Scholar 

  110. Brune IB, Feussner H, Neuhaus H, Classen M, Siewert JR. Laparoscopic gastrojejunostomy and endoscopic biliary stent placement for palliation of incurable gastric outlet obstruction with cholestasis. Surg Endosc. 1997;11(8):834–7.

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE, 68198, USA

    Randeep S. Jawa M.D. & David W. Mercer M.D.

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  1. Randeep S. Jawa M.D.
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  2. David W. Mercer M.D.
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Correspondence to Randeep S. Jawa M.D. .

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  1. Science Center, Department of Surgery, The University of Texas Health, 6431 Fannin Street, MSB 4.292, Houston, 77030, Texas, USA

    Laura J. Moore

  2. The Methodist Hospital, Department of Surgery, Weill Cornell Medical College, 6550 Fannin St, SM 1661A, Houston, 77030, Texas, USA

    Krista L. Turner

  3. School of Medicine, Department of Surgery, New York University, 550 First Avenue, New Bellevue 15 East 9, New York, 10016, New York, USA

    S. Rob Todd

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Jawa, R.S., Mercer, D.W. (2013). Gastric Outlet Obstruction. In: Moore, L., Turner, K., Todd, S. (eds) Common Problems in Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6123-4_18

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