Palliative bypass operation for y-limb obstruction due to peritoneal recurrence of gastric carcinoma, report of five cases

Abstract

Palliative bypass operations were performed in five cases with Y-limb obstruction due to peritoneal recurrence of gastric carcinoma. One distal gastrectomy and four total gastrectomies had formerly been done. All five cases underwent Roux-en-Y reconstruction. The histological type of gastric carcinoma was poorly differentiated adenocarcinoma in all patients. Peritoneal dissemination and/or intraperitoneal lavage cytology were positive in four cases. The average period from gastric resection to bypass surgery was 448 days, and from bypass surgery to death 82 days. Four cases could be discharged from the hospital, and two required home infusion therapy with parenteral nutrition. The average home stay period was 38 days. The clinical course of a 67 year-old lady is described as a representative case. Y-limb obstruction requires emergent treatment. However, it is difficult to decide surgical indications because of patients being end stage. Medical treatments should be given to every patient based on informed consent.