Battle Of The Surgeries: Roux-En-Y Vs. Loop Gastrojejunostomy For Benign Gastric Outlet Obstruction A Prospective Cohort Study

Abstract

Introduction

Gastrojejunostomy is a surgical procedure involving creating an anastomosis between the stomach and the proximal loop of the jejunum. There is a paucity of data comparing the outcome of Roux-en-Y (RY) versus loop gastrojejunostomy (LG) in benign gastric outlet obstruction. Therefore, the current study aimed to assess the pre-, peri-, and postoperative parameters and complications of RY and LG in patients with benign gastric outlet obstruction.

Method

This prospective cohort study was conducted at Hayatabad Medical Complex, Peshawar, Pakistan, between January 2019 and January 2022. The study aimed to assess the outcomes of gastrojejunostomy in patients who chose to undergo the surgery compared to those who chose not to. Patients who needed gastrojejunostomy were included, and those with specific exclusion criteria were excluded. Baseline data were collected, and participants were followed up for two years to assess the outcomes of the treatment. The primary outcome was the incidence of complications related to gastrojejunostomy, and the secondary outcomes included changes in body weight, nutritional status, quality of life, and overall survival. The data were analyzed using appropriate statistical methods and reported according to the STROBE guidelines.

Results

The mean age of the LG group patients was higher than in the RY group (p<0.0001). The BMI was slightly higher in the RY group compared to the LG group (23±1 vs 22±1). The time taken by the RY operation was quite high compared to the LG technique (p<0.0001). Regarding the postoperative complications, there was no significant difference between the two groups. However, the incidence of biliary gastritis was high in the LG group compared to the RY group, and the difference was statistically significant (p = 0.008).

Conclusion

The study compared Roux-en-Y (RY) and loop gastrojejunostomy (LG) in patients with benign gastric outlet obstruction. The results showed that both techniques were safe and effective, but the choice of technique should be individualized based on patient characteristics and surgeon preference. The incidence of biliary gastritis was higher in the LG group compared to the RY group. Further studies are needed to confirm these findings.