A Gastrojejunostomy is the surgical creation of an opening in the stomach to connect it to the upper portion of the small bowel, or small intestine, so that the surgeon can place a tube into the opening. The tube allows medications and nutritional liquids to be given through the tube directly into the stomach. Gastrojejunostomies are performed on patients who cannot eat normally or take medicine orally due to a blockage or cancer of the stomach or pancreas. Some patients who have a condition that causes an obstructed bowel may undergo a gastrojejunostomy if they are unable to have a nasogastric tube, a tube that runs from the nose into the stomach.
This procedure is typically performed with surgery, where an incision is made in the stomach. Precutaneous gastrojejunostomies are performed through a very small incision, much smaller than that usually required for a normal gastrojejunostomy. Interventional radiologists perform precutaneous gastrojejunostomies, and these procedures usually result in fewer complications and quicker recovery times.
Patients preparing for a gastrojejunostomy should not eat or drink for at least six hours prior to surgery so that there is no fresh food or liquid in the stomach. Patients should advise their doctors and surgeons of any medications they are currently taking prior to surgery. Some medications, such as blood thinners, may need to be reduced or stopped several weeks prior to surgery to minimize the risk of excessive bleeding and other potential complications. Patients should also advise their doctors of any allergies, previous reactions to anesthesia, and any chronic health conditions.
Gastrojejunostomies are performed under general anesthesia, usually given intravenously through an IV line. Precutaneous gastrojejunostomy procedures are usually done with a local anesthetic and sleeping medication. Patients who have precutaneous gastrojejunostomies still require an IV line so that the surgeon can administer fluids, painkillers, antibiotics, and other medications as necessary.
An ultrasound is usually used to help the surgeon or interventional radiologist determine where to place the gastrojejunostomy tube. The tube is usually placed right before the rib cage. The patient's stomach is inflated with air through a tube that runs through the nose into the stomach so that the surgeon can place the tube properly. Precutaneous gastrojejunostomies involve the stomach being fastened to the inside of the abdomen with small clips that are inserted through the skin. The clips are removed once the procedure is complete.
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