Surgical procedures

Within 14 days of enrolment, patients underwent surgical palliation by either distal/total gastrectomy or gastrojejunostomy. Further points of obstruction in the small bowel or colon leading to concurrent small bowel/colonic bypass, small bowel/colonic resection, ileostomy/colostomy and catheter ileostomy were all allowed, but placement of an endoscopic stent was not. The choice of treatment was left to the discretion of the physician performing the surgical procedure. A Devine bypass procedure with transection of the stomach and anastomosis between the jejunal loop and the proximal stump of the divided stomach¹¹, or a modified procedure with gastric partitioning, was also allowed. Patients who underwent diagnostic laparotomy alone on the basis of intraoperative findings were included.