Is Jaboulay gastroduodenostomy effective for treating duodenal stricture due to duodenal ulcer in the early postoperative term? Clinical consideration.

BACKGROUND/AIMS: Indications for surgery in patients with duodenal ulcers have changed radically. Gastric outlet obstruction (GOO) is a complication that can result from duodenal ulcers. From the perspective of organ preservation, gastroduodenostomy (e.g. Jaboulay procedure) is ideal for the treatment of GOO due to duodenal ulcer-induced stricture; however, delayed gastric emptying is frequently observed postoperatively. We compared the short-term clinical outcomes of Jaboulay procedure with those of antrectomy.

METHODOLOGY: We retrospectively studied 30 patients who underwent surgery for GOO due to duodenal ulcer. The patients were divided into the J group (those who underwent highly selective vagotomy with Jaboulay gastroduodenostomy) and the A group (those who underwent highly selective vagotomy and antrectomy with Billroth II reconstruction).

RESULTS

The mean duration of nasogastric suction, number of days until diet initiation, number of days until oral ingestion of solid food and postoperative duration of hospitalization were significantly shorter in the A group than in the J group. Moreover, delayed gastric emptying was significantly less frequent in the A group than in the J group.

CONCLUSIONS

Considering the short-term postoperative outcomes, we believe that highly selective vagotomy and antrectomy with Billroth II reconstruction are the preferred procedures for duodenal ulcer-induced GOO.