Back to 2025 Abstracts
COMPARATIVE OUTCOMES OF GASTRIC RESECTION VS GASTROJEJUNOSTOMY IN THE SURGICAL TREATMENT OF ACID-INDUCED GASTRIC OUTLET OBSTRUCTION: A PILOT STUDY
Utpal Anand
*, Bijit Saha
All India Institute of Medical Sciences, Patna, Patna, Bihar, India
Background: The optimum surgical approach for acid-induced gastric strictures, whether gastrectomy or gastrojejunostomy, remains a subject of ongoing debate. This prospective randomized pilot study aims to assess and compare the surgical outcomes and quality of life (QOL) between patients undergoing gastric resection and gastrojejunostomy.
Patients and Methods: Between May 2022 and October 2023, our department treated 60 patients with corrosive-induced injuries. Among these patients, 30 cases presented with isolated gastric strictures and were randomly assigned to one of two treatment groups: gastric resection (n=15) or bypass surgery via gastrojejunostomy (n=15). The primary objective of this study was to compare surgical outcomes and quality of life (QOL) between patients undergoing gastric resection and gastrojejunostomy. Standardized questionnaires, including the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) and the European Organization for Research and Treatment of Cancer Stomach 22-item module (EORTC-STO-22), were used to assess QOL. All analyses were conducted according to both Intention-to-Treat (ITT) and Per-Protocol (PP) principles to ensure robust and reliable results (Fig 1).
Results: The gastric resection group demonstrated superior outcomes, with a lower incidence of delayed gastric emptying (12.5% vs. 50%, p=0.046), shorter hospital stays (6.40 vs. 9.20 days, p=0.014), and reduced reflux esophagitis (6.2% vs. 42.8%, p=0.031) (Table 2). Quality of life assessments using the WHOQOL-BREF questionnaire revealed significantly better physical (p=0.003, 0.001, 0.001) and psychological (p=0.025, 0.008, 0.004) outcomes in the resection group at 3, 6, and 9 months. Furthermore, the EORTC-STO-22 questionnaire indicated lower pain (p=0.019, 0.024, 0.016) and fewer reflux symptoms (p=0.024, 0.008, 0.005) in the resection group. Conversely, the bypass group exhibited shorter operative times (86.00 vs 118 minutes, p=0.024) and reduced blood loss (100.60 vs 148.80 ml, p<0.001) (Table 1).
Conclusion: Gastric resection is the preferred treatment approach for acid-induced gastric outlet obstruction, offering a favorable profile of fewer postoperative complications, improved functional outcomes, and enhanced quality of life.
Back to 2025 Abstracts
