Gastrojejunostomy / Pyloroplasty - Khobragade Multispeciality Hospital

What is Gastrojejunostomy?

Gastrojejunostomy is a surgical procedure that creates a direct connection between the stomach and the jejunum (a part of the small intestine). It is primarily performed to bypass a blocked or narrowed pylorus or duodenum, allowing food to move directly from the stomach into the small intestine. This helps in cases where the normal passage of food is impaired due to conditions like gastric outlet obstruction, stomach cancer, or peptic ulcer disease.Pyloroplasty is a surgical technique used to widen the pyloric sphincter, the muscular valve between the stomach and the duodenum. This facilitates easier passage of food and is often used in conjunction with other procedures or as a treatment for pyloric stenosis, gastroparesis, or recurrent peptic ulcers.

Symptoms Indicating the Need for Surgery

Patients suffering from conditions that may require Gastrojejunostomy or Pyloroplasty typically experience:

Nausea and vomiting
Severe abdominal pain or discomfort after eating
Bloating and early satiety
Weight loss or malnutrition
Recurrent gastric ulcers
Food retention in the stomach
Obstruction symptoms due to tumor or scarring

Procedure or Treatment

Gastrojejunostomy Procedure:

Performed either through open surgery or laparoscopically, this procedure involves:

General anesthesia is administered.
An incision is made in the abdomen.
The surgeon connects the lower part of the stomach to the jejunum, bypassing the duodenum.
The new connection allows food to move directly into the small intestine.

This surgery is often indicated in:

Gastric cancer with obstruction
Chronic pancreatitis
Peptic ulcer complications
Palliative care for unresectable tumors

Pyloroplasty Procedure:

Under anesthesia, the pylorus muscle is surgically cut and restructured to widen the outlet.
This allows stomach contents to pass more freely into the duodenum.
Often done alongside vagotomy (cutting of vagus nerve) to reduce acid secretion in ulcer patients.

Both procedures are followed by hospital observation, gradual reintroduction of food, and recovery monitoring to ensure normal digestion resumes.

Prevention and Management

While surgery is often a last resort, several steps can help manage or reduce the risk of conditions leading to obstruction:

Timely treatment of ulcers and gastritis
Avoiding NSAIDs and alcohol abuse
Regular monitoring in patients with gastric cancer
Managing chronic conditions like diabetes that can cause gastroparesis
Early detection and management of digestive tumors

Benefits of Gastrojejunostomy / Pyloroplasty

Restores normal digestion
Relieves symptoms such as nausea, vomiting, and abdominal pain
Improves nutrition and weight gain
Enhances quality of life in palliative care
Allows for non-obstructed passage of food
Reduces complications associated with chronic ulcers or gastric stasis

Types of Gastrojejunostomy

Antecolic Gastrojejunostomy – Jejunum is brought in front of the colon.
Retrocolic Gastrojejunostomy – Jejunum is passed behind the transverse colon.
Roux-en-Y Gastrojejunostomy – A more complex reconstruction involving a long jejunal limb, often used in gastric bypass surgeries or cancer cases.

Types of Pyloroplasty

Heineke-Mikulicz Pyloroplasty – The most common method, involving a longitudinal cut and transverse closure of the pylorus.
Finney Pyloroplasty – A more extensive form used when a larger opening is needed.
Jaboulay Pyloroplasty – A side-to-side anastomosis between the stomach and duodenum, bypassing the pylorus without cutting it.