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Gastrojejunostomy: helping food get past a blocked duodenum | CION Cancer Clinics
A gastrojejunostomy joins the stomach directly to a loop of small bowel, so food can get past a tumour blocking the duodenum. It is used for cancers of the pancreas, duodenum, bile duct or lower stomach that cause vomiting and early fullness. It eases eating and does not remove the cancer. This page covers the warning signs, how it compares with a stent and what recovery involves. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is a gastrojejunostomy and why is it done?
- What are the signs that food is not getting through?
- How does surgery compare with a stent in the duodenum?
- What happens in the days after the operation?
- Who is a gastrojejunostomy not suitable for?
- What do families often believe about this operation?
- What do the words on the report mean?
- Common questions about gastrojejunostomy
The short answer
What is a gastrojejunostomy and why is it done?
A gastrojejunostomy is an operation that joins the stomach directly to a loop of small bowel. It gives food a new way out of the stomach when a tumour is blocking the duodenum, the first part of the bowel just past the stomach.
What a blocked duodenum feels like
Food normally leaves the stomach through the duodenum. A cancer of the pancreas, the duodenum, the bile duct or the lower stomach can narrow that passage. Food then sits in the stomach. People feel full after a few mouthfuls, bring up food eaten hours earlier and lose weight quickly because so little gets through.
What the operation changes
The surgeon brings a loop of small bowel up to the stomach and stitches the two together, making a new opening above the blockage. Food now leaves the stomach through this new route and carries on through the rest of the bowel as usual. Doctors call this blockage gastric outlet obstruction.
A gastrojejunostomy does not remove the tumour. It goes around it, so that eating becomes possible again.Recognising it
What are the signs that food is not getting through?
These often creep up over weeks. Families sometimes put them down to the illness or to treatment, when a blockage is the cause.
Vomiting food from earlier
Bringing up food eaten many hours before, sometimes undigested, points to food sitting in the stomach rather than passing on.
Fullness after very little
Feeling full and bloated after a few spoonfuls, with a swollen upper belly, is common as the passage narrows.
Weight falling quickly
When little food gets through, weight drops fast. Weakness, dizziness on standing and very little urine can follow.
Needs same-day care if
- Even water will not stay down
- Urine becomes very dark or scanty
How it is confirmed
A CT scan and an endoscopy, a camera test through the mouth, show where the narrowing is and how tight it has become. They also show whether the bile duct is blocked too, and whether there are other narrowings further down the bowel, which changes what can help.
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How does surgery compare with a stent in the duodenum?
Duodenal stent
Gastrojejunostomy
A mesh tube placed through the narrowing by endoscope
An operation that joins the stomach to the bowel
No cut, and eating often restarts within a day or two
A general anaesthetic, and eating restarts more slowly
More likely to block again as the tumour grows
Tends to keep working for longer
Often chosen when time or strength is limited
Often considered when someone is fitter
The recovery
What happens in the days after the operation?
-
Before surgery
A thin tube through the nose may be used to empty the stomach, and a drip corrects dehydration and salts. If weight loss has been severe, the team may build up nutrition first.
-
The operation
It is done under general anaesthesia, through a cut in the upper belly or by keyhole. The stomach is joined to a loop of small bowel, above the blockage.
-
The first days
Sips of water come first. The stomach can be slow to push food into the new route, so nausea and bloating are common. Food moves on to liquids and then soft meals only as each stage stays down.
-
Going home
The stay is often around a week, longer if the stomach is slow to empty. At home, small soft meals several times a day work better than a few large ones.
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The weeks at home
Tiredness is common and lifts slowly. A short walk each day, no heavy lifting while the wound heals and a note of your weight every few days help the team see how you are doing. If chemotherapy is planned, the oncologist will wait until you are eating and healing well. Vomiting old food again, or a swollen upper belly, means the new route may not be working and should be reported the same day.
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Being straight with you
Who is a gastrojejunostomy not suitable for?
This is a real abdominal operation, offered to people who are often already thin and weak. It is usually not suggested for someone very frail, with a lot of fluid in the belly, or with several blockages further down the bowel, because a new join above one blockage would not help.
What the team weighs
They look at fitness, nutrition, how far the cancer has spread, whether the bile duct is also blocked and what other treatment is planned. They also think about how long recovery would take against the time the illness may allow. When recovery would take up much of that time, a stent is often the gentler route.
What this page cannot tell you
It cannot tell you which option suits your family member, or how long eating will stay comfortable. That depends on their scans and their strength. Ask the surgeon why an operation is proposed rather than a stent, and what happens if the stomach is slow to empty afterwards.
Commonly believed
What do families often believe about this operation?
"The vomiting is just the chemotherapy."
Treatment can cause sickness, but vomiting old food and early fullness suggest a blockage. It is worth telling the team, because a blockage needs a different kind of help from anti-sickness medicine.
"After the bypass he can eat whatever he likes."
The new route lets food through, but the stomach may stay slow and the appetite low for a while. Small, soft, frequent meals are usually easier, and a dietitian can guide what to add.
"A liquid diet at home will solve it."
Liquids may pass for a while, but they rarely provide enough nutrition and the narrowing usually tightens. Waiting too long leaves someone weaker for any procedure. Speak to the team early.
"Joining the stomach to the bowel means it was removed."
Nothing is removed in a gastrojejunostomy. The stomach stays, and a new opening is made. Removing part of the stomach is a different operation.
On your report
What do the words on the report mean?
- Gastric outlet obstruction
- A blockage where food leaves the stomach.
- Duodenum
- The first part of the small bowel, curving around the head of the pancreas.
- Jejunum
- The next stretch of small bowel, which is joined to the stomach.
- Delayed gastric emptying
- A stomach slow to pass food on after surgery. It usually improves with time.
- Ryles tube
- The thin tube through the nose that keeps the stomach empty.
Questions we are asked
Common questions about gastrojejunostomy
When can he start eating after a gastrojejunostomy?
Sips of water usually start within the first days, then liquids and soft food as each stage stays down. Some people move quickly. Others need longer because the stomach is slow to empty. The team will guide each step, and it is better not to rush it with large meals.
Is it done by keyhole?
It can be done by keyhole in suitable people, or through a cut in the upper belly. The choice depends on previous surgery, how the tumour sits and the surgeon's experience. Ask your centre which approach they plan and why.
What if the stomach is slow to empty after surgery?
This is one of the more common problems. It causes nausea, bloating and vomiting even though the join is open. It is usually managed with a nose tube to rest the stomach, medicines that help it move and patience. It tends to improve with time.
Is a stent safer than surgery?
A stent avoids an operation and usually lets eating restart sooner. It can block again as the tumour grows. Surgery takes longer to recover from but tends to last. Neither is safer for everyone. Your team weighs fitness, the scans and what else is planned.
Will the bile duct need a bypass too?
Sometimes the same tumour also blocks the bile duct, causing jaundice. In that case a bile duct stent, or a bile bypass done in the same operation, may be discussed. Ask whether the bile duct is affected now and what the plan would be if it becomes blocked later.
What food is easiest at home?
Small, soft, moist meals every few hours are usually easiest. Khichdi, idli, curd rice, dal and soft vegetables often suit. Very oily, spicy or fibrous food can sit heavily. If weight keeps falling, ask for a dietitian and about nutritional supplements.
What are the risks of this operation?
Like any abdominal operation, there can be bleeding, wound or chest infection and blood clots. More specific are slow stomach emptying and, less often, a leak from the join. Ask your surgeon how these are watched for and what would be done.
Is it covered by Aarogyasri or insurance?
It is usually covered when it is part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card or policy details and we will check your cover before admission.
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Sources
- American Cancer Society — Surgery for pancreatic cancer
- American Cancer Society — Surgery for stomach cancer
- Cancer Research UK — Treatment for pancreatic cancer
- National Cancer Institute — Pancreatic cancer treatment (PDQ), patient version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Double Bypass for Bile and Food BlockageWhen the bile duct is blocked as wellSurgical Bypass vs Stent: How the Choice Is MadeHow teams weigh surgery against a stentBiliary Bypass: Relieving a Blocked Bile DuctThe bile duct side of the same problemRecovery, Eating and Getting Back to LifeEating and energy in the weeks at home
Talk to us
Food not staying down?
Send us the scans and endoscopy report, or call the helpline. A surgical oncologist will explain whether a stent or a bypass is being considered and why. One helpline serves every CION centre.