Jaboulay strictureplasty vs gastrojejunostomy: morbidity

What is known

• In the Birmingham series, early complications (fistula, obstruction) and long-term restricture were more frequent after duodenal strictureplasty than gastrojejunostomy; no bypass patient needed reoperation for early complications. ¹
• That series concluded strictureplasty has no obvious advantage over gastrojejunostomy for obstructive duodenal Crohn's. ¹
• Gastrojejunostomy morbidity was later reoperation for stomal ulceration (2/13) and anastomotic obstruction (4/13); vagotomy was not clearly protective. ¹
• One small series reported bypass patients were slow to regain intestinal function (~20%), needing parenteral nutrition and prolonged stays, whereas strictureplasty avoids blind loop, bile reflux, and vagotomy/stomal ulceration. ^1,2

What is unknown / caveats

• Birmingham series found strictureplasty had higher early complications than bypass; other single-arm series report strictureplasty as safe with no postoperative complications
• Jaboulay is described as a form of strictureplasty in some texts and as a gastroduodenostomy bypass in others, so the two arms are not cleanly separable
• No head-to-head Jaboulay vs gastrojejunostomy data
• All evidence is small retrospective cohorts of a rare condition, mixing strictureplasty types and bypass configurations
• The specific Jaboulay-versus-gastrojejunostomy comparison the question asks about is not addressed by any retrieved study.

References

1. Yamamoto T, Bain IM, Connolly AB, Allan RN, Keighley MR. Outcome of strictureplasty for duodenal Crohn's disease. Br J Surg. 1999;86(2):259-62. PMID: 10100799.

2. [No authors listed]. Strictureplasty is an effective option in the operative management of duodenal Crohn's disease. Dis Colon Rectum. 1999;42(5):596-600. PMID: 10344680.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.