{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:25:20Z","timestamp":1791563120220,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Malignant gastric outlet obstruction (GOO) has traditionally been managed with enteral stenting and surgical gastrojejunostomy. Our study aimed to compare outcomes between endoscopic ultrasound\u2010guided gastrojejunostomy (EUS\u2010GJ) using a lumen\u2010apposing metal stent and robotic GJ (R\u2010GJ) for unresectable malignant GOO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing EUS\u2010GJ or R\u2010GJ for unresectable malignant GOO were retrospectively analyzed. The primary outcome was clinical success defined by the ability to tolerate oral intake at the time of discharge. Secondary outcomes included technical success, procedure duration, adverse events, and post\u2010procedure length of stay (LOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 44 patients met the inclusion criteria. Of the 44, 29 underwent EUS\u2010GJ and 15 underwent R\u2010GJ. Age, gender, malignant etiology, and presence of ascites were similar between the two groups. Patients treated with EUS\u2010GJ had a higher mean Charlson comorbidity index (10.3 vs. 7.0; <jats:italic>p \u2264<\/jats:italic> 0.0001) and a lower preoperative body mass index (22.3 vs. 27.2; <jats:italic>p<\/jats:italic> = 0.007). Technical and clinical success was achieved in 100% of patients in both groups (<jats:italic>p<\/jats:italic> &gt; 0.99). EUS\u2010GJ was associated with shorter procedure duration (57.5 vs. 146.3 min; <jats:italic>p<\/jats:italic> &lt; 0.0001), hospital LOS (4.3 vs. 8.2 days, <jats:italic>p<\/jats:italic> = 0.0009), and time to oral intake (1.0 vs. 5.8 days; <jats:italic>p<\/jats:italic> &lt; 0.0001) when compared to R\u2010GJ. Adverse events occurred in 5 of the R\u2010GJ patients and none of the EUS\u2010GJ patients (<jats:italic>p<\/jats:italic> = 0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EUS\u2010GJ has similar efficacy and superior clinical outcomes compared to R\u2010GJ in the management of malignant GOO. Prospective studies with longer follow\u2010up duration are needed to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/deo2.248","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T07:33:51Z","timestamp":1684827231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Endoscopic ultrasound\u2010guided gastrojejunostomy versus robotic gastrojejunostomy for unresectable malignant gastric outlet obstruction"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6452-2359","authenticated-orcid":false,"given":"Rishi","family":"Pawa","sequence":"first","affiliation":[{"name":"Department of Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J","family":"Koutlas","sequence":"additional","affiliation":[{"name":"Department of Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Russell","sequence":"additional","affiliation":[{"name":"Biostatistics and Data Science Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perry","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Pawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-021-02215-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2712-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0130-9"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.09.042"},{"key":"e_1_2_7_6_1","first-page":"299","article-title":"Palliative management of malignant antro\u2010pyloric strictures. 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