Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

Table 2 Systematic review of laparoscopic gastrojejunostomy for gastrict obstruction due to advanced hepatobiliary cancer

Ref.	n	Type of study	HPB Etiology	Biliary obstruction	Operating time	Perioperative morbidity	Time to initiate intake	Time to solid food	LOS	Duration of food intake	Comment
All HPB Malignancy
Jeurnink et al[60], 2007	95	Cohort: GJ (42) vs duodenal stent (53)	GJ: All patients (laparoscopy: 10)	GJ: 17 previous treatment	ND	GJ: 4 major (hemorrhage, severe pain, cholangitis, respiratory failure); 13 minor (mild pain, wound infection, nausea and vomiting)	ND	GJ: 10.1 ± 4.8 d	GJ: 18d (4-55)	ND
Hamade et al[4], 2005	21	Cohort: laparoscopic GJ/CJ/GJ+CJ	All patients	5 biliary bypass, 8 GJ+biliary bypass	gastric bypass 75 min, GJ+CJ 130 min	1 pneumonia, 1 central line sepsis, 1 wound abscess	ND	ND	4 d (1-14)	9 patients untill death	Includes pre-treatment, profilactic and terapeutic GJ
Denley et al[9], 2005	18	Case series: LGJ	All patients	ND	ND	2 reconversions, 1 leak, 1 sepsis, 1 DGE	ND	ND	6 (3-22)	15 patients untill death
Kazanjian et al[5], 2004	9	Case series: LGJ	All patients	ND	116 min (75-300)	1 DGE, 1 Cholangitis	ND	4 d (3-6)	7 d (5-18)	ND	4 patient previous stent
Alam et al[61], 2003	8	Case series: LGJ	All patients	ND	135 min	Pneumonia (1)	ND	4 (2-7)	7 (5-13)	7 patients untill death
Kuriansky et al[62], 2000	12	Case series: LGJ+biliary bypass	All patients	12 CCJ	89.16 min (35-150)	2 wound infection, 1 pneumonia, 2 DGE, 1 reintervention (bleeding)	ND	ND	6.4 (5-17)	All patients untill death
Casaccia et al[63], 1999	6	Case series: LGJ	All patients	4 ES. 2 Laparoscopic CCJ	82 min (60-135)	1 Bleeding (transfusion)	ND	ND	4.5 (4-6)	ND
Casaccia et al[64], 1998	5	Case series: LGJ	All patients	4 ES. 1 laparoscopic CCJ	ND	1 Bleeding (transfusion)	ND	ND	4 (4-6)	ND
Rhodes et al[65], 1995	16	Case series: laparoscopic CCJ ± GJ (5GJ, 3 both, 9CCJ)	All patients	ND	75 min	1 DGE, 1 ictus	ND	ND	4 d (3-33)	ND	Results of the entire data series
Wilson et al[57], 1992	2	Case series: LGJ	All patients	ND	120 min	None	2d	3 d, 4 d	4-5 d	1 patient untill death
Mixed malignancies
Zhang et al[66], 2011	28	Case series: LGJ for benign/malignant disease	7 HPB malignancy	ND	170 min	2 reinterventions (anastomotic leak, trocar site hemorrhage), 2 bleeding controlled by endoscopy, 1 ileus, 5 DGE	3d	5 d	8 d (2-83)	ND	Results of the entire data series
Guzman et al[3], 2009	20	Cohort: LGJ AND OGJ	Laparoscopy: 8 HPB malignancy	ND	116 min	2 DGE	ND	7 d	8 d	ND
Navarra et al[67], 2006	24	RCT: 12 LGJ vs 12 OGJ	Laparoscopy: 5 HPB malignancy	ND	150 min	None	ND	4.08 d	11 d	ND
Mehta et al[39], 2006	27	RCT: 14 LGJ vs 13 SEMS	ND	6 patients (ES, PD)	ND	2 bleeding, 1 wound infection, 1 pneumonia, 3 DGE. 3 mortality (sepsis, pneumonia, carcinomatosis)	ND	ND	11.4 D	ND
Al-Rashedy et al[68], 2005	26	Cohort: LGJ and OGJ	Laparoscopy: 7 HPB malignancy	ND	ND	2 (13.3%)	ND	ND	3 (3-8)	ND
Khan et al[69], 2005	19	Case series: laparoscopic CCJ ± GJ (16 GJ, 1 CCJ, 2 both)	7 HPB malignancy	2 CCJ	164 min single bypass, 245 min double bypass	ND	3d	ND	ND	ND
Mittal et al[37], 2004	56	Cohort: 16 OGJ, 14 LGJ, 16 ES.	Laparoscopy: 9 HPB malignancy	None patient	ND	4 pneumonia, 1 ileus, 1 wound infection	ND	5 d (4-8)	13.5 d (6-36) (after procedure 7d)	ND
Bergamaschi et al[70], 2002	55	Case/control: antiperistaltic vs isoperistaltic LGJ	AP-LGJ: 29 HPB malignancy, IP-LGJ 14 HPB malignancy	ND	100min (AP) vs 99min (IP)	14 (II: 1, III: 9, IV: 3)	ND	5.1d (AP) vs 5.3 d (IP)	8.4 d (AP) vs 8.1 d (IP)	ND
Bergamaschi et al[71],1998	22	Case /control: OGJ (prophylactic and GOO treatment) vs LGJ (GOO treatment)	Laparoscopy: 9 HPB malignancy	1 ES, 3 PD	94 min	Pneumonia (1), SSI (1), delayed gastric emptying (1)	ND	8.4 (media)	18.4 (media)	ND
Brune et al[15], 1997	16	Case series: LGJ	13 HPB malignancy	ES/PD	126 min (70-210)	1 reintervention (hemorrhage), 3 delayed gastric emptying	ND	ND	4.7 (2-8)	16 patients untill death
Nagy et al[72], 1995	10	Case series: LGJ	9 HPB malignancy	8 ES/1 PD/ 2 simultaneous CJ	ND	2 reconversions, 1 CCF, 1 pneumonia, 1 CD infection	ND	10 d (4-15)	ND	All patients untill death

HPB: Hepatopancreatic-biliary; LOS: Length of stay; LGJ: Laparoscopic gastrojejunostomy; OGJ: Open gastrojejunostomy; ND: Not described; GOO: Gastric outlet obstruction; CCJ: Cholecystojejunostomy; CJ: Choledochojejunostomy; ES: Endoscopic stent; PD: Percutaneous drainage; AP: Antiperistaltic; IP: Isoperistaltic; CCF: Congestive cardiac failure; RCT: Randomized controlled trial; CD: Clostridium difficile; DGE: Delayed gastric emptying.