Salehi O, Gao WL, Kenfield C, Hebbard G. Roux-en-Y jejunostomy in gastroparesis: Insight into patient perspectives and outcomes. World J Gastrointest Surg 2025; 17(3): 102543 [DOI: 10.4240/wjgs.v17.i3.102543]
Corresponding Author of This Article
Omar Salehi, MD, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, 300 Grattan Street, Parkville 3052, Victoria, Australia. omar.salehi@mh.org.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2025; 17(3): 102543 Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.102543
Roux-en-Y jejunostomy in gastroparesis: Insight into patient perspectives and outcomes
Omar Salehi, Wei-Lun Gao, Christian Kenfield, Geoff Hebbard
Omar Salehi, Wei-Lun Gao, Geoff Hebbard, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Parkville 3052, Victoria, Australia
Christian Kenfield, Department of General Surgery, Melbourne Private Hospital, Parkville 3052, Victoria, Australia
Author contributions: Salehi O and Gao WL conducted patient interviews, performed data collection and analysis, prepared the figures and tables, and wrote the manuscript; Salehi O conducted thematic analysis of interview transcripts and coordinated study logistics; Gao WL assisted with data interpretation and manuscript revisions; Hebbard G conceptualized and designed the study, provided clinical oversight and critically revised the manuscript for important intellectual content; Kenfield C developed the surgical approach, provided technical expertise, contributed to study design, and critically reviewed the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Royal Melbourne Hospital, approval No. QA2022100.
Informed consent statement: All involved participants gave their verbal informed consent prior to study inclusion. All participants provided informed consent prior to completing the questionnaire. Identifying details were removed during analysis to protect patient privacy. Participants were assigned a unique ID number for reference.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Omar Salehi, MD, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, 300 Grattan Street, Parkville 3052, Victoria, Australia. omar.salehi@mh.org.au
Received: October 22, 2024 Revised: December 22, 2024 Accepted: January 14, 2025 Published online: March 27, 2025 Processing time: 125 Days and 20 Hours
Abstract
BACKGROUND
Gastroparesis is a chronic motility disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. Patients with refractory gastroparesis often require enteral nutrition support, but traditional feeding methods such as nasojejunal tubes and percutaneous gastrojejunostomy tubes have significant limitations including frequent displacement, infection, and impact on quality of life.
AIM
To explore patients’ experience post insertion of laparoscopic Roux-en-Y jejunostomy in a cohort of eight adult patients with idiopathic gastroparesis.
METHODS
Eight patients with idiopathic gastroparesis who underwent Roux-en-Y jejunostomy placement between 2019-2022 were interviewed about their pre- and post-procedure experiences. The procedure involves creating a jejunal limb anastomosed to the proximal jejunum in a Y-configuration, with the limb brought to the abdominal wall for feeding tube insertion. This is designed to reduce leakage by diverting intestinal contents away from the stoma. Topics included symptoms, nutrition, quality of life, and comparison to previous feeding methods.
RESULTS
Post-procedure, all patients reported improvements in nausea/vomiting, and 87.5% noted reduced abdominal pain. Weight stabilized and oral intake improved in 75% of patients. Most (87.5%) described improved social confidence, increased energy, and better work/school functioning. Three patients (37.5%) eventually maintained adequate oral nutrition without jejunostomy. Minor complications included leakage (37.5%) and hypergranulation tissue. Half the cohort used supplemental gastric venting. Most patients (87.5%) preferred Roux-en-Y jejunostomy over previous feeding tubes and would undergo the procedure again.
CONCLUSION
Despite some challenges, Roux-en-Y jejunostomy led to notable improvements in symptoms, nutrition, and quality of life for most patients with refractory gastroparesis. It may be a viable option for long-term enteral nutrition support in carefully selected patients. Further research is needed to optimize patient selection and manage complications.
Core Tip: This qualitative study provides novel insights into patient experiences with Roux-en-Y jejunostomy for refractory gastroparesis. While traditional feeding tubes often have limitations, this surgical approach showed promising outcomes for symptom control and quality of life. Notable findings improvement and/or resolution of nausea/vomiting in most patients, with 37.5% eventually maintaining adequate oral nutrition without jejunostomy. The study highlights the potential of Roux-en-Y jejunostomy as a viable long-term feeding option in carefully selected patients, while also identifying ongoing challenges such as leakage and hypergranulation tissue that require proactive management.
