How is a gastrojejunostomy performed?
A gastrojejunostomy is a surgical procedure performed under general anesthesia by a gastrointestinal surgeon. The surgeon produces a direct connection (anastomosis) between the stomach and the jejunum, part of the small intestine.
Prior to a gastrojejunostomy a patient may be required to
- Undergo blood, urine and imaging tests.
- Avoid eating or drinking 8 hours prior to the procedure.
- Check with the doctor before taking any regular medications.
- Inform the doctor of any allergies.
A precautionary course of antibiotics may be given to the patients. Stabilization of patients with severe gastric outlet obstruction may be done prior to the surgery. Treatment may be undertaken for problems such as
- Dehydration -- with IV saline
- Low potassium -- with supplemental potassium
- Anemia from bleeding -- with blood transfusion
- Residual stomach contents -- with stomach pumping (gastric lavage)
- An anesthesiologist administers anesthesia and monitors the patient’s vital functions during the procedure.
- The patient will be intubated to provide oxygen.
- The surgeon makes one or more incisions in the abdomen depending on the type of surgery.
- In case of removal or bypass of the stomach outlet (pylorus) and duodenum, the surgeon makes a surgical outlet in the stomach (stoma) and connects the jejunum directly to the stomach (anastomosis).
- If the surgeon removes a part of the stomach, the remaining portion of the stomach will be connected to the jejunum.
- The anastomosis may be closed with sutures or staples.
- The abdominal muscles and the incision are closed with sutures.
- The patient will be brought out of anesthesia and administered painkillers for post-surgical pain.
- The patient will be monitored in the recovery room for several hours.
- Percutaneous gastrojejunostomy does not require general anesthesia. The doctor may use local anesthetic and mild sedation.
- Guided by ultrasound imaging the doctor inserts a needle along with a guiding wire, in the stomach wall.
- The feeding tube may be placed in the jejunum either by
- pushing through the stomach wall, or
- passing the tube through the nose, down the upper digestive tract to the jejunum and pulled out of the stomach wall.
- The needle and guiding wire are withdrawn.
- Endoscopic gastrojejunostomy is a minimally invasive procedure. A light sedation may be used along with painkillers.
- A flexible viewing tube (endoscope) is advanced through the nose, esophagus, stomach, and duodenum into the jejunum.
- The procedure will be guided by images on the monitor.
- If there is obstruction in the duodenum and the scope cannot get through, a needle is used to puncture the stomach and enter the jejunum.
- A self-expanding metal stent is placed in the jejunum.
- The endoscope is gently withdrawn.
How long does it take to recover from a gastrojejunostomy procedure?
The recovery time depends on the type of procedure and the patient’s underlying condition.
- For an open surgery the patient may require 10 or more days of hospitalization.
- Laparoscopic surgery may require hospitalization of two to three days.
- Complete recovery from the surgery may take up to six weeks during which period the patient may be required to
- follow a specific diet
- avoid spicy and acidic foods
- avoid heavy lifting
- avoid strenuous activities
With percutaneous and endoscopic gastrojejunostomy the patient may be able to recover within 24 hours. Temporary procedures will require reversal. Complete recovery depends on the underlying condition of the patient.
What are the risks and complications of a gastrojejunostomy?
Surgeons routinely perform gastrojejunostomy and it is a relatively safe surgery. The severity of risks and complications mostly depend on the underlying condition of the patient.
The risks include:
- Side effects of anesthesia such as
- Risks of surgery such as
- wound infection
- blood clots
- damage to internal organs, blood vessels or nerves
- Anastomotic leakage
- Anastomotic stricture
- Complications of other accompanying surgeries such as vagotomy or gastrectomy
- Gastric dumping syndrome due to the stomach contents emptying too quickly into the intestine
- Bile reflux and chronic gastritis
- Bowel blockage
- Inflammation of the stomach lining (peritonitis)
- Weight loss and fatigue
- Infection and sepsis
- Lack of relief from the underlying condition
- Percutaneous and endoscopic gastrojejunostomy are technically safe procedures. The main risk from these procedures are
- Lack of relief from symptoms
- Short-term efficacy
- Pain and infection at the puncture site
Health Solutions From Our Sponsors
Top How Long to Recover from A Gastrojejunostomy Related Articles
Crohn's Disease vs. Ulcerative ColitisCrohn's disease and ulcerative colitis are diseases that cause inflammation of part of or the entire digestive tract (GI). Crohn's affects the entire GI tract (from the mouth to the anus), while ulcerative colitis or ulcerative colitis only affects the large and small intestine and ilium. Researchers do not know the exact cause of either disease. About 20% of people with Crohn's disease also have a family member with the disease. Researchers believe that certain factors may play a role in causing UC. Both Crohn's disease and ulcerative colitis are a type of inflammatory bowel disease or IBD. Crohn's disease and ulcerative colitis both have similar symptoms and signs, for example, nausea, loss of appetite, fatigue, weight loss, episodic and/or persistent diarrhea, fever, abdominal pain and cramping, rectal bleeding, bloody stools, joint pain and soreness, eye redness, or pain. Symptoms unique to Crohn’s disease include anemia and skin changes. Symptoms of unique to ulcerative colitis include certain rashes, and an urgency to defecate (have a bowel movement). Doctors diagnose both diseases with similar tests and procedures. While there is no cure for either disease, doctors and other health care professionals can help you treat disease flares, and manage your Crohn's or ulcerative colitis with medication, diet, nutritional supplements, and/or surgery.
GastroparesisGastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Peptic Ulcer (Stomach Ulcer)Peptic or stomach ulcers are ulcers in the lining of the stomach, duodenum, or esophagus. Learn about symptoms, causes, diet, and treatment.
What Is Gastric (Stomach) Cancer? Signs, Symptoms, CausesWhat are the common signs and symptoms of stomach cancer? Learn about gastric cancer diagnosis, treatment, and their risks, how Heliobacter pylori affects the stomach, what the risk factors are, and how clinical trials have helped determine cancer risks. Guard your gastrointestinal health with reliable medical information.
Weight Loss Challenges: Why Can't I Lose Weight?Finding it difficult to lose weight? It’s a hard thing to do, and there are some surprising reasons you may not be losing weight as quickly as you hope. From sleep cycles to calorie counts, health food fakers to prescription drugs, learn many of the stumbling blocks that can prevent you from reaching your health goals.
Weight Loss QuizAre you trying to lose weight? Take this quiz to see what you can add to routine to get on the right track for results!
Weight Loss Surgery QuizWhat happens after weight loss surgery? What should you eat? Take this quiz to learn about bariatric surgery. Are you a candidate?
Weight Loss Surgery: What to ExpectAre you considering weight loss (bariatic) surgery? WebMD helps you know what makes you a good candidate and the pros and cons of the different operations.
What Is a Partial Gastrectomy?A partial gastrectomy is the surgical removal of a portion of the stomach, as opposed to a total gastrectomy in which the entire stomach is removed. This may be done for people with stomach cancer or severe gastric ulcer disease.
What Is Distal Gastrectomy Surgery?Antrectomy (distal gastrectomy) is a procedure that involves surgical removal of the lower 30% of the stomach (antrum). Surgeons follow removal by creating an attachment with an opening (anastomosis) from the remaining portion of the stomach to the duodenum (gastroduodenostomy) or the jejunum (gastrojejunostomy) of the small intestine. This surgery treats severe gastric ulcers and stomach tumors.
What Is the Surgical Procedure for Pyloroplasty?The pylorus is the lowermost part of the stomach, where it connects to the beginning of the small intestine (duodenum). Pyloroplasty is a surgical procedure to widen the pylorus by cutting and relaxing the pyloric sphincter muscle of the stomach.