Evidence map›Paper›PMID 35648229›Full record

ArticleLangenbeck's archives of surgery2022

Endoscopic duodenal stenting is efficient, but has higher rate of reoperations than gastrojejunostomy in palliative treatment for gastric outlet obstruction.

Matti Laitamäki, Tuula Tyrväinen, Juho T Lehto, Johanna Laukkarinen, Mika Ukkonen

Open access · hybridAbstract read
In one paragraph

Article in Langenbeck's archives of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Matti LaitamäkiDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Kuntokatu 2, 33520, ElämänaukioTampere, Finland. matti.laitamaki@fimnet.fi.ORCID http://orcid.org/0000-0002-1042-2448
Tuula TyrväinenDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Kuntokatu 2, 33520, ElämänaukioTampere, Finland.
Juho T LehtoFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Johanna LaukkarinenDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Kuntokatu 2, 33520, ElämänaukioTampere, Finland.
Mika UkkonenDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Kuntokatu 2, 33520, ElämänaukioTampere, Finland.
Tampere University · FITampere University of Applied Sciences · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical gastrojejunostomy has traditionally been the palliative treatment of choice for patients with advanced malignancies and gastric outlet obstruction syndrome. Recently, palliative endoscopic duodenal stenting has increased in popularity. We report outcomes after gastrojejunostomy and duodenal stenting when used for palliative indications.

methodsConsecutive patients undergoing palliative gastrojejunostomy or palliative endoscopic duodenal stenting in a Finnish tertiary referral center between January 2015 and December 2020 were included. The postoperative outcomes of these two palliative interventions were compared. The main outcome measures were mortality and morbidity, rate of reoperations, postoperative oral intake ability, and length of hospital stay.

resultsA total of 88 patients, 46 (52%) patients underwent palliative gastrojejunostomy and 42 (48%) duodenal stenting. All patients had malignant disease, most typically hepatopancreatic cancer. Nineteen (44%) patients in duodenal stenting group and 4 (8.7%) patients in gastrojejunostomy group required subsequent interventions due to persisting or progressing symptoms (p < 0.001). Median delay until first oral intake was 2 days (1-24) after gastrojejunostomy and 0 days (0-3) after stenting (p < 0.001). Postoperative morbidity was 30% after gastrojejunostomy and 45% after stenting (p < 0.001). Median length of hospital stay was 7 days (1-27) after surgery and 5 days (0-20) after endoscopy (p < 0.001).

conclusionsPatients undergoing endoscopic duodenal stenting are more able to initiate rapid oral intake and have shorter hospital stay. On the other hand, there are significantly more reoperations in stenting group. If the patient's life expectancy is short, we recommend stenting, but for patients whose life expectancy is longer, gastrojejunostomy could be a better procedure, for the reasons mentioned above.

Indexed as

Gastric BypassGastric Outlet ObstructionEndoscopy, GastrointestinalHumansPalliative CareReoperationRetrospective StudiesStentsTreatment OutcomeDuodenal stentingGastric outlet obstructionGastrojejunostomyPalliative carePalliative surgery

Identifiers

PMID35648229
PMCPMC9468122
OpenAlexW4281759089

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.