AzTrials
AzTrials

Malignant Gastric Outlet ObstructionNCT05986890

Roux-en-Y Gastric Bypass Versus Loop Gastrojejunostomy for Malignant Gastric Outlet Obstruction

A study testing Roux-en-Y Bypass and gastrojejunostomy in people with Malignant Gastric Outlet Obstruction, run by Corewell Health West at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

This study is intended to investigate whether roux-en-y bypass surgery is superior to conventional loop gastrojejunostomy for Malignant gastric outlet obstruction in terms of tolerance to solid food intake. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Malignant Gastric Outlet Obstruction
What is being tested?
Roux-en-Y Bypass and gastrojejunostomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteUnited States
Study dates
17 Aug 2023to 13 Jul 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provision of signed and dated informed consent form.
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Male or female aged ≥18 years old.
  • Patients with a diagnosis of malignant gastric outlet obstruction. i. Defined as malignant cancer growth of any organ origin in the area of the distal stomach or duodenum preventing normal gastric emptying as determined by symptoms and cross-sectional imaging studies.
  • Symptoms can include abdominal distention, abdominal pain, nausea and vomiting.
  • Cross sectional imaging findings can include tumor growth in the area of the distal stomach or duodenum, gastric distention, fluid filled stomach and decompressed bowel distal to obstruction point.
  • Patients deemed to benefit from surgical bypass as opposed to stent placement, by the primary surgeon. This includes assessing participants survival chances and ability to undergo a surgical procedure.
  • Patients in a general health status that permits abdominal surgery under general anesthesia. As determined by primary surgeon and anesthesiologist.

Who cannot join

  • Patients that have had previous treatment for malignant gastric outlet obstruction.
  • Including any previous surgery or stent placement for MGOO
  • Patients with MGOO deemed to benefit more from endoscopic stent placement rather than surgery for symptom relief. This assessment will be at treating surgeon's discretion.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Corewell Health West

    Grand Rapids, Michigan, 49503

Other trials in United States

About this study

This study is intended to investigate whether roux-en-y bypass surgery is superior to conventional loop gastrojejunostomy for Malignant gastric outlet obstruction in terms of tolerance to solid food intake. We hypothesize that roux-en-y bypass will be associated with improved solid food intake in the first 30 days after surgery.

Read the detailed description

Malignant gastric outlet obstruction is when malignant tumor growth obstructs the gastric outlet at the level of the distal stomach or duodenum, causing food intolerance with nausea and vomiting. Most often, this signifies advanced neoplastic disease with associated poor prognosis for patients. Restoring patients to oral intake is important for palliative purposes. The current standard of care in patients requiring long-term alleviation of symptoms (≥2 months) is performing a loop gastrojejunostomy. This involves creating an intestinal bypass to the site of obstruction in the duodenum or distal stomach. This procedure has long been criticized for its poor resultant function for patients, mainly due to poor tolerance to food intake that include frequent episodes of nausea and vomiting and inability to for solid food intake. The need for a durable solution to malignant gastric outlet obstruction that provides better tolerance to solid food intake is evident. The roux-en-y gastric bypass procedure has been performed for a variety of indications for decades, most commonly for weight loss but also with oncologic resections of the stomach in cases of gastric cancer. Laparoscopic roux-en-y gastric bypass (R-Y bypass) has become the standard for this procedure in experienced hands and has been found to be safe in the short- and long term. The long-term function after R-Y bypass is generally favorable across published literature. No studies exist to compare loop gastrojejunostomy to roux-en-y gastric bypass in patients with malignant gastric outlet obstruction.

Being tested
Roux-en-Y Bypass, gastrojejunostomy
Keywords
MGOO, Malignant gastric outlet obstruction, gastric outlet, malignant tumor, proximal bowel obstruction, bowel obstruction
Medical subject headings
Neoplasms, Intestinal Obstruction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Roux-en-Y BypassProcedure or surgery

    laparoscopic Roux-en-Y

  • gastrojejunostomyProcedure or surgery

    surgical gastrojejunostomy

Study groups in NCT05986890
Study groupRoleWhat they receive
Roux-en-Y BypassOtherlaparoscopic Roux-en-Y (R-Y) procedure is a well-established procedure, commonly utilized in the setting of bariatric- and gastric cancer surgery. The procedure establishes intestinal continuity that bypasses the distal stomach and duodenum. This is achieved by dividing the jejunum 30-40 cm distal to the ligament of Treitz, bringing the distal end of jejunum up anterior to the transverse colon to be anastomosed to the back wall of the stomach (forming the Roux-limb). The proximal cut end of jejunum then gets anastomosed to the downstream roux-limb (forming the Y-limb). The benefits of this reconstruction include less chance of gastric contents travelling into the afferent limb and similarly, avoiding bile reflux from the afferent limb with associated bile gastritis.
Receives: Procedure: Roux-en-Y Bypass
GastrojejunostomyOthersurgical gastrojejunostomy, a procedure dating back to the late 1800's.5 This surgical bypass consists of connecting the stomach to a loop of proximal small bowel, thus bypassing any duodenal or distal gastric obstruction.
Receives: Procedure: gastrojejunostomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Gastric emptying as per gastric emptying scintigraphy at 7 days post-operatively.

    Results of this study are given as percentage gastric emptying of radioactive (99mTc-SC) nutrients

    Measured: 7 days post operative

Secondary outcomes (8)
  1. Gastric emptying study at 30-days

    Results of this study are given as percentage gastric emptying of radioactive (99mTc-SC) nutrients

    Measured: 30 days post operative

  2. Patient reported daily gastric outlet obstruction scoring system (GOOS) score

    Patients will score each day with the score that reflects the diet that was tolerated that day by the patient. This includes what was able to be ingested without a subsequent vomiting.

    Measured: 30 days postoperative

  3. Number of Clavien-Dindo grade ≥3 adverse event

    Measured: 14 days postoperative

  4. Number of patients requiring reoperation for any indication

    Measured: 30 days postoperative

  5. number of patients with diagnoses of delayed gastric emptying defined as per the International Study Group of Pancreatic Surgery

    Measured: 30 days postoperative

  6. Time from surgery to death

    Measured: 100 days postoperative

  7. Improvement of quality of life as measured by short form QOL Questionnaire

    The short form 36 question QOL questionnaire results in a cumulative score with an increase in score representing a better health-related quality of life

    Measured: measured pre-operatively, at 25-35 days post op and 80-100 days post op

  8. Improvement of quality of life as measured GIQLI

    The Gastrointestinal quality of life questionnaire results in a cumulative score with an increase in score representing a better health-related quality of life

    Measured: measured pre-operatively, at 25-35 days post op and 80-100 days post op

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Aug 2023
  2. Study start17 Aug 2023
  3. Primary completion13 Jul 2026
  4. Study completion13 Jul 2026

Why it stopped: The study was terminated early due to poor participant accrual, resulting in inadequate enrollment to support the planned analysis and study endpoints.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05986890
Sponsor's protocol ID
2022-433
Status last verified
Jul 2026
First submitted
3 Aug 2023
Last updated
16 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Weaver DW, Wiencek RG, Bouwman DL, Walt AJ. Gastrojejunostomy: is it helpful for patients with pancreatic cancer? Surgery. 1987 Oct;102(4):608-13.

    PubMed 2443991
  • Lillemoe KD, Cameron JL, Hardacre JM, Sohn TA, Sauter PK, Coleman J, Pitt HA, Yeo CJ. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial. Ann Surg. 1999 Sep;230(3):322-8; discussion 328-30. doi: 10.1097/00000658-199909000-00005.

    PubMed 10493479
  • Egrari S, O'Connell TX. Role of prophylactic gastroenterostomy for unresectable pancreatic carcinoma. Am Surg. 1995 Oct;61(10):862-4.

    PubMed 7545358
  • Del Piano M, Ballare M, Montino F, Todesco A, Orsello M, Magnani C, Garello E. Endoscopy or surgery for malignant GI outlet obstruction? Gastrointest Endosc. 2005 Mar;61(3):421-6. doi: 10.1016/s0016-5107(04)02757-9.

    PubMed 15758914
  • ROBINSON JO. The history of gastric surgery. Postgrad Med J. 1960 Dec;36(422):706-13. doi: 10.1136/pgmj.36.422.706. No abstract available.

    PubMed 13742310
  • Doberneck RC, Berndt GA. Delayed gastric emptying after palliative gastrojejunostomy for carcinoma of the pancreas. Arch Surg. 1987 Jul;122(7):827-9. doi: 10.1001/archsurg.1987.01400190093020.

    PubMed 2439057
  • Navarra G, Musolino C, Venneri A, De Marco ML, Bartolotta M. Palliative antecolic isoperistaltic gastrojejunostomy: a randomized controlled trial comparing open and laparoscopic approaches. Surg Endosc. 2006 Dec;20(12):1831-4. doi: 10.1007/s00464-005-0454-5.

    PubMed 17063298
  • Mintziras I, Miligkos M, Wachter S, Manoharan J, Bartsch DK. Palliative surgical bypass is superior to palliative endoscopic stenting in patients with malignant gastric outlet obstruction: systematic review and meta-analysis. Surg Endosc. 2019 Oct;33(10):3153-3164. doi: 10.1007/s00464-019-06955-z. Epub 2019 Jul 22.

    PubMed 31332564
  • Johnsson E, Thune A, Liedman B. Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting: clinical outcome and health economic evaluation. World J Surg. 2004 Aug;28(8):812-7. doi: 10.1007/s00268-004-7329-0. Epub 2004 Aug 3.

    PubMed 15457364
  • Singh SM, Longmire WP Jr, Reber HA. Surgical palliation for pancreatic cancer. The UCLA experience. Ann Surg. 1990 Aug;212(2):132-9. doi: 10.1097/00000658-199008000-00003.

    PubMed 1695834
  • Lucas CE, Ledgerwood AM, Saxe JM, Bender JS, Lucas WF. Antrectomy. A safe and effective bypass for unresectable pancreatic cancer. Arch Surg. 1994 Aug;129(8):795-9. doi: 10.1001/archsurg.1994.01420320017001.

    PubMed 7519417
  • Mittal A, Windsor J, Woodfield J, Casey P, Lane M. Matched study of three methods for palliation of malignant pyloroduodenal obstruction. Br J Surg. 2004 Feb;91(2):205-9. doi: 10.1002/bjs.4396.

    PubMed 14760669
  • Bergamaschi R, Marvik R, Thoresen JE, Ystgaard B, Johnsen G, Myrvold HE. Open versus laparoscopic gastrojejunostomy for palliation in advanced pancreatic cancer. Surg Laparosc Endosc. 1998 Apr;8(2):92-6.

    PubMed 9566559
  • Telford JJ, Carr-Locke DL, Baron TH, Tringali A, Parsons WG, Gabbrielli A, Costamagna G. Palliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study. Gastrointest Endosc. 2004 Dec;60(6):916-20. doi: 10.1016/s0016-5107(04)02228-x.

    PubMed 15605006
  • Jeurnink SM, Steyerberg EW, van Hooft JE, van Eijck CH, Schwartz MP, Vleggaar FP, Kuipers EJ, Siersema PD; Dutch SUSTENT Study Group. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc. 2010 Mar;71(3):490-9. doi: 10.1016/j.gie.2009.09.042. Epub 2009 Dec 8.

    PubMed 20003966

Questions about this trial

What is this clinical trial studying?

A study testing Roux-en-Y Bypass and gastrojejunostomy in people with Malignant Gastric Outlet Obstruction, run by Corewell Health West at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 16 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: The study was terminated early due to poor participant accrual, resulting in inadequate enrollment to support the planned analysis and study endpoints.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Gastric emptying as per gastric emptying scintigraphy at 7 days post-operatively. (time frame: 7 days post operative). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05986890, which also lists 28 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in