Related Experiment Video
Updated: Mar 12, 2026
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Risk-adjusted Precision Reconstruction in Gastric Outlet Obstruction: A Prospective Cohort Demonstrating Superior
Tushar Saini1, Saurabh Singla2, Sanjay Kumar3
1Department of Surgical Gastroenterology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India.
Background:
Delayed gastric emptying (DGE) is the most common complication following palliative gastrojejunostomy (GJ) for gastric outlet obstruction. Whether roux-en-Y (RY) reconstruction offers a clinical edge over the loop configuration remains unclear.
Materials And Methods:
The prospective cohort study included 41 patients who received either RY (n = 19) or loop (n = 22) GJ. The main study endpoint consisted of composite DGE (ISGPS Grades A/B/C) within 30 days. The research used multivariable logistic regression to determine independent risk factors.
Results:
DGE occurred in 22% overall, significantly less with RY (5%) than loop (36%; P = 0.024). RY remained protective after adjustment (adjusted odds ratio: 0.10; P = 0.053), while malignancy and male sex increased risk. Length of stay and serious morbidity were similar across groups.
Conclusions:
RY-GJ may markedly reduce postoperative DGE without added morbidity. Despite promising findings, the small sample size and nonrandomized design warrant cautious interpretation. Further validation in randomized trials is needed before routine use.
