A 73‐year‐old male presented to a local doctor with abdominal distension and was admitted to our hospital for suspected gastric cancer. Following examinations, he underwent surgery for gastric cancer with obstruction. We later diagnosed him with stage IV omental metastasis. Gastric cancer involving the pancreas was highly advanced, and non‐resective bypass surgery was performed．
As the elevated jejunal anastomosis was superior and anterior to the stomach, the patient had an increased risk of postoperative transit obstruction, and jejunostomy was performed. After surgery, the patient found it difficult to eat some foods, but was quickly able to self‐manage his jejunostomy and discharged. He received chemotherapy using SOX (4 courses) and PTX (1 course) regimens． In some cases, chemotherapy can be postponed or discontinued for patients with delayed oral initiation and lower performances status (PS) after palliative surgery for gastric cancer with obstruction. In this case, chemotherapy was insufficient to improve the observed obstruction, and maintenance of nutritional support was made possible by jejunostomy. The patient left the hospital without a reduced PS and received chemotherapy as an outpatient． jejunostomy, gastric cancer, obstruction

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