Endoscopic Ultrasound-Guided Gastroenterostomy vs Duodenal Stenting vs surgical Gastrojejunostomy for the Treatment of Malignant Gastric Outlet Obstruction; Review Article

Background: Gastric outlet obstruction (GOO) is a clinical condition caused by a mechanical blockage of the upper digestive tract at the level of the distal stomach, pylorus or duodenum. Often encountered in the context of advanced malignancy, it is associated with debilitating symptoms including intractable nausea and vomiting, inability to tolerate oral nutrition, abdominal pain and decreased quality of life.
Objective: The aim of the review is to evaluate endoscopic ultrasound-guided gastroenterostomy vs duodenal stenting vs surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction.
Methods: PubMed, Google scholar and Science direct were searched using keywords. The author also screened references from the relevant literature, including all the identified studies and reviews, only the most recent or complete studies were included, which were published between 1992 and 2022. Documents in a language apart from English have been excluded as sources for interpretation was not found. Papers apart from main scientific studies had been excluded: documents unavailable as total written text, conversation, conference abstract papers and dissertations.
Conclusion: Ultrasound-guided gastroenterostomy (EUS-GE) is emerging as a potential treatment option for GOO. When compared to duodenal stenting and surgical gastrojejunostomy (SGJ), EUS-GE may provide a longer lasting treatment for GOO. In the hands of experts, EUS-GE appears to be similar in efficacy and safety when compared to surgery; yet it may be less costly.