关键词: 晚期胃癌, 胃幽门梗阻, 分隔式胃空肠吻合术, 腹腔镜

Abstract: To observe the safety and perioperative efficacy of total laparoscopic stomach-partitioning gastrojejunostomy in the treatment of advanced gastric cancer combined with gastric outlet obstruction (GOO). Methods  The clinical data of 45 patients with advanced gastric cancer combined with GOO admitted to the Department of Gastrointestinal Nutrition and Hernia Surgery of the Second Hospital of Jilin University between September 2021 and June 2023 were retrospectively analyzed, and they were divided into the group of stomach-partitioning gastrojejunostomy (using total laparoscopic stomach-partitioning gastrojejunostomy, n=16) and the group of conventional gastrojejunostomy (using total laparoscopic conventional gastrojejunostomy, n=29) based on the intraoperative gastrojejunal anastomosis methods. Compare the perioperative clinical indexes of the two groups and analyze the effects of different surgical methods on the perioperative recovery of GOO patients . Results    The differences between patients in the stomach-partitioning gastrojejunostomy group and the conventional gastrojejunostomy group were not statistically significant in terms of intraoperative bleeding, first time of out-of-bed activity, discharge albumin, discharge GOOSS , and the incidence of postoperative complications (P>0.05). Compared with the conventional gastrojejunostomy group, patients in the stomach-partitioning gastrojejunostomy group had a longer operation time and a shorter time to to the following: first postoperative water intake, postoperative drain and gastric tube removal, gastroenterography gastric half-emptying, gastric complete-emptying, first postoperative enteral nutrition, and discharge after surgery, with statistically significant differences (P<0.05); despite one patient in the stomach-partitioning gastrojejunostomy group had gastroparesis, the difference was not statistically significant (P>0.05). Conclusion    Compared with total laparoscopic conventional gastrojejunostomy, total laparoscopic stomach-partitioning gastrojejunostomy has obvious advantages in the recovery of the postoperative gastrointestinal function, postoperative hospitalization time, and postoperative feeding time without increasing the intraoperative bleeding and postoperative complications although the increased difficulty of the operation led to a prolonged operative time, and it is recommended for popularization and application. 

Key words: advanced gastric cancer, gastric outlet obstruction, stomach-partitioning gastrojejunostomy,  , laparoscopy