Gastric and/or duodenal retention can occur due to:
· tumor-compression of the duodenum
· development of stricture caused by infiltration from tumor
· duodenal stenosis
· reduced motility
To relieve an identified anatomical obstruction in the stomach/duodenum, an operation with gastro-entero-anastomosis is an option. An operation involving gastro-enterostoma relief can be performed laparoscopically.
Endoscopically installed self-expanding metal stents may be an option for patients with advanced disease.
The functional outcome is not always satisfactory, patients may have nausea and vomiting caused by metabolic factors associated with tumor disease. Indications for surgery must be weighed against life expectancy without surgery.
It is not proven that parenteral nutrition provides better tumor treatment effect or generally increases the quality of life or life expectancy in patients.
Due to nausea and anorexia, enteral tube feeding can be useful for some patients, although many may find the tube troublesome.
Different nutritional supplements and vitamins can be seen as beneficial by many patients and relatives, but there is no proven efficacy in studies. Recently, it is shown that some omega-3 polyunsaturated fatty acids, especially eicosapentaenoic acid, increases the effect of oral nutrition supplements, and may be given a place in supporting the treatment.
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