Palliation of advanced gastric cancer by laparoscopic gastrojejunostomy

Palliation of unresectable gastric carcinoma by conventional gastrojejunostomy is associated with significant morbidity and mortality. Laparoscopic gastrojejunostomy may be an alternative as it can achieve the same results with less morbidity. This is a case report of a 68-year-old man with an obstructed, unresectable gastric carcinoma that has metastasized to the lungs and liver. Attempt at laser boring was unsuccessful. Laparoscopic assessment revealed an immobile tumour fixed to the pancreas. A totally intraabdominal laparoscopic gastrojejunostomy was fashioned with endoGIAs (USSC Norwalk, CT). Operation time was 85 minutes. He was able to tolerate feeds on the 3rd postoperative day (POD), diet on the 5th POD and was discharged on the 8th POD. Satisfactory palliation at home was achieved for ten weeks before death. Laparoscopic gastrojejunostomy is thus a good option for palliation of obstructed advanced gastric cancer.