Surgical Experience in Gastric Outlet Obstruction in Eastern India– A Retrospective Analysis

Abstract

Background: Gastric outlet obstruction (GOO), occurs due to obstruction at pylorus. it is not a single entity but it is the clinical and pathophysiological consequence of many disease processes that leads to a mechanical impediment to gastric emptying.

Methods: Total patients 178patients attending the Department of General Surgery IIMSR Haldia from April 2016 to March 2019 with chief complaints of projectile vomiting, visible gastric peristalsis, or palpable distended stomach, diagnosed as GOO from UGI endoscopy and barium meal study were included in this study. Cases of the functional non-mechanical causes of GOO were excluded, along with the paediatric age group. Only patients of 12 years and above were included in this study.

Results: Out of 178 cases of GOO, 92 cases had neoplastic etiology (carcinoma stomach- 63, carcinoma gall bladder-20, periampullary-7, carcinoma colon-2), 48 patients to PUD, 22 had a pseudocyst of the pancreas, 6 had post-surgical stricture due to duodenal perforation repair in the past, 5 had tubercular and corrosive etiology each. 71 cases (39.3%) cases were labourers. The most common age group for presentation was 61-70 years, with 52 cases (29.21 %). Feeding jejunostomy (FJ) was the most common surgical procedure, with 88 cases (49.4%), as most patients were malnourished and nutrition was improved for definitive surgery. Morbidity in this study was 36 cases (18.1 %) with mortality of 2 cases (1.1%)

Conclusion: GOO due to neoplastic etiology followed by Pud is common in eastern India; multimodal treatment in a staged manner for GOO patients has good clinical outcomes and few complications.