# Impact of Palliative Gastrojejunostomy Type on Survival in Patients with Unresectable Pancreatic Head Cancer: A Retrospective Analysis

## TL;DR

This study finds that the type of gastrojejunostomy surgery affects survival in patients with advanced pancreatic cancer.

## Contribution

The study identifies specific surgical techniques (Roux-en-Y and Omega with Braun anastomosis) that improve survival compared to a simple Omega loop.

## Key findings

- Roux-en-Y anastomosis was associated with a 53% lower risk of death compared to the simple Omega loop.
- Omega loop with Braun anastomosis showed a 50% lower risk of death compared to the simple Omega loop.
- Age was a significant independent predictor of mortality in these patients.

## Abstract

Gastrojejunostomy (GJ) is used as a palliative procedure in patients with inoperable pancreatic head cancer. While its primary goal is to relieve obstruction, clinical observations suggest the type of reconstruction may influence survival. Objectives: The objective of this study was to compare overall survival in patients undergoing different types of palliative gastrojejunostomy. Methods: A retrospective analysis was performed on 240 patients with inoperable pancreatic cancer. Patients were divided into three groups: Roux-en-Y (n = 186), Omega loop with Braun anastomosis (n = 36), and simple Omega loop (n = 18). A multivariable Cox proportional hazards model was used to assess the risk of death, adjusting for age and sex. Results: In the multivariable analysis, the Roux-en-Y anastomosis was associated with a significantly lower risk of death compared to the simple Omega loop (HR = 0.47; 95% CI: 0.28–0.79; p = 0.004). Similarly, the Omega loop with Braun anastomosis demonstrated a significant survival benefit compared to the simple Omega loop (HR = 0.50; 95% CI: 0.27–0.93; p = 0.029). Age was a significant independent predictor of mortality. Conclusions: The type of gastrojejunostomy significantly influences survival in patients with advanced pancreatic cancer. Both Roux-en-Y and Omega with Braun anastomosis offer superior survival outcomes compared to simple Omega loop gastrojejunostomy. These benefits may be attributable to complex metabolic and hormonal mechanisms, which warrant further investigation in prospective studies.