Key principles

• Performed for a variety of reasons, often to bypass diseased pylorus / duodenum

I perform a 2 layer handsewn gastrojejunostomy creating a long stoma on the anterior aspect of the stomach

Operation Details

GA. Supine
Upper midline laparotomy
Select appropriate loop of jejunum which reaches up to anterior stomach (20-30cm)
- Bring it antecolic or retrocolic
Place back wall with continuous double armed 3/0 PDS seromuscular
Open stomach and jejunum parallel to seromuscular suture and 0.5cm away from it.
- Make 4-6cm long for benign disease, longer for malignant
Using double armed 3/0 PDS starting in middle begin suturing inner layer in continuous fashion taking all layers.
- Use Connell at lateral aspects to get around corner. Complete inner layer
Place anterior wall with continuous 3/0 PDS
Standard closure

• Standard • Anastomotic leak • Dumping