A gastrojejunostomy procedure is a gastric bypass or "Roux-En-Y" surgery used if you're unable to eat due to stomach cancer obstructing the passage of food in to your gut.
It's an option in those who are not going to be cured of their cancer as a palliative procedure and may even help to prolong life.
It is sometimes performed when a curative operation is attempted, but failed due to evidence of tumour spread at the time of your operation.
In the past, the operation was performed as an ‘open’ procedure through a large incision in your abdominal wall.
However, most procedures are now carried out by keyhole or laparoscopic techniques.
A part of your small bowel known as the jejunum is opened and stitched or clipped on to your stomach wall as demonstrated in the picture below.
The gastrojejunostomy bypass procedure 'bypasses' the obstructed area of stomach caused by your cancer.
Rather than surgery, sometimes a gastrojejunostomy tube is inserted instead. This is placed either endoscopically or via an x-ray or radiological procedure.
The procedure takes about an hour. A local anesthetic (numbing medicine) is injected just under your skin. A small tube is then passed down your nose into your stomach and air will is injected into this tube. Using X-ray equipment to guide the x-ray doctor, stitches called retention sutures are placed to secure your stomach to the muscles underneath your skin. The Radiologist then places the tube through your skin into your stomach over a guide wire and this is passed through into your stomach and then down into your small bowel (jejunum).
Your surgeon will advise and provide patient information as to when you can start taking oral fluids first.
Normally you should be able to drink adequate amounts of fluid anything between 4 to 9 days post-surgery.
When you are able to tolerate oral fluids, foods will be introduced.
These need to be small (maybe as much as 6-8 times a day), but regular meals as your stomach won’t have the capacity to take large meals.
Fatty foods may be an issue, so start with carbohydrate foods such as potato, pasta, fruits and then slowly introduce meats, poultry and dairy products.
Foods need to be chewed well and needs to be swallowed slowly to allow your food to pass easily.
Taking drinks in between mouthfuls of food may also aid transit of your food through in to your gut.
A gastrectomy diet is a really good option when you have had a this procedure and you can read more about diet in the treatment section of the website.
Alternatively, I have published a book on the subject called "The Art Of Eating Without A Stomach", do take a look as it's packed full of useful information.
Complications or 'side effects' can arise from any form of surgery, including this procedure.
These include immediate gastrojejunostomy complications such as bleeding, wound breakdown and peritonitis, blood clots and infections (including pneumonia) and even death.
Later complications can include fat malabsorption, B12 and iron deficiency, diarrhea, stricture (narrowing) and a condition called dumping syndrome due to rapid emptying of food from your stomach.
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