Gastrojejunostomy is a type of gastric/intestinal bypass procedure. It connects your stomach directly to the middle part of your small intestine (jejunum), bypassing the first part (duodenum).
A gastrojejunostomy is a surgical procedure that creates a new connection (anastomosis) between your stomach and the middle section of your small intestine, called the jejunum. The new connection reroutes the passage of food from your stomach into your small intestine, bypassing the first section of your small intestine, called the duodenum.
Sometimes the term, “gastrojejunostomy,” is used to describe a minor procedure to place a feeding tube in your small intestine. The tube is called a gastrojejunostomy tube because it passes through your stomach and duodenum into your jejunum (mid-intestine). This is a different procedure, however — called a percutaneous gastrojejunostomy.
You might need your food to bypass your duodenum if your duodenum has a medical problem or isn’t working correctly — for example, if it’s blocked. The problem could also be in your lower stomach (antrum). If the outlet at the bottom (pylorus) isn’t allowing food to pass through, sometimes the solution is to attach your small intestine to the upper part of your stomach.
Gastrojejunostomy can also be part of a weight loss surgery procedure. The Roux-en-Y gastric bypass is one type of gastrojejunostomy. This procedure bypasses part of your stomach along with your duodenum. The purpose of the bypass in this case is to reduce the amount of food your stomach can hold and the amount of nutrients your small intestine can absorb.
You might have a gastrojejunostomy to treat:
Less commonly, you might have a preventative gastrojejunostomy to avoid complications if you have:
Depending on the condition you’re being treated for, you may need other treatments before you’re ready for surgery. For example, if your gastrointestinal tract has been blocked, you’ve probably had some trouble keeping food down. You may have been vomiting a lot and may be dehydrated and/or malnourished.
Your healthcare team will want you to be in the best health possible before surgery. They may treat you first with:
There are different variations to the procedure, but in general, your surgeon will:
It usually takes between two and four hours.
You’ll be admitted to the hospital after surgery. It can take some time before you’re ready to tolerate solid food. You might have some nausea, or your bowels might be slow to move after surgery (paralytic ileus). In some cases it takes a long time for the stomach to empty through the new connection. Some people need to keep a nasogastric tube in for several days.
You might stay on IV fluids and nutrition at first, or you might begin with a clear liquid diet and gradually transition to a soft diet before going home. Occasionally, it can take several weeks for your stomach to start working again after surgery. In this case, you may continue to be fed through a tube or an IV.
Certain risks come with any surgical procedure, including:
Additional risks with gastrojejunostomy include:
It takes an average of six weeks to recover. It may take more or less time, depending on how extensive your operation was and whether you had open or laparoscopic surgery. You may have had part of your stomach and part of your small intestine divided or removed. If you had cancer, you might have had additional tissue removed, as well.
Your healthcare team will instruct you on how to care for your incision wound(s), how to manage your pain at home and when you can resume your regular activities. They’ll schedule a follow-up appointment with your healthcare provider a few weeks after you go home. At the appointment, they’ll check you for any signs of complications in your recovery.
You may have to follow a special diet for several months after your operation. The specifics will depend on how much of your stomach and/or intestine was removed and whether you’re experiencing symptoms of dumping syndrome. You may have to watch your nutrition more carefully than before, take vitamin supplements and avoid foods high in sugar.
Contact your healthcare team if:
There’s no standard definition of “major” vs. “minor” surgery, so the answer depends on your perspective. On the one hand, any surgery that alters your gastrointestinal tract is a big deal. It’s relatively complicated and takes several hours. It changes the natural course of your digestive system, and you might experience side effects afterward.
On the other hand, the procedure can often be done using minimally-invasive techniques. That means you don’t necessarily have to have open abdominal surgery, which involves a long incision through your abdomen and a longer healing time. Depending on your condition and your surgeon, you may be able to have laparoscopic surgery instead.
Laparoscopic surgery is a less invasive alternative to open surgery. It’s all done through smaller, half-inch “keyhole” incisions in your abdomen. A tiny camera called a laparoscope goes into one of the keyholes and projects images onto a screen while the surgeon operates through other keyholes. These incisions heal relatively quickly and with less pain.
A note from Cleveland Clinic
A gastrojejunostomy alters your digestive system significantly (and usually permanently). While this may be beneficial or even necessary for your condition, it’s nevertheless a big transition. Ask for all the help you need as you prepare for the procedure and for your diet and lifestyle adjustments afterward. Your healthcare team is there to advise you at every step.
Last reviewed by a Cleveland Clinic medical professional on 11/02/2022.
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