{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:59:55Z","timestamp":1785373195185,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["13004\/2020\u20131"],"award-info":[{"award-number":["13004\/2020\u20131"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a paucity of data on the cost\u2010utility of endoscopic ultrasonography\u2010guided gastroenterostomy (EUS\u2010GE) compared with surgical gastrojejunostomy (SGJ) as palliative treatment of malignant gastric outlet obstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In the ENDURO trial, 98 patients with malignant gastric outlet obstruction from 12 Dutch hospitals were randomized between EUS\u2010GE (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a048) and SGJ (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a050). Cost utility was evaluated from a healthcare perspective with a time horizon of 1\u00a0month. A bottom\u2010up approach was used to calculate the costs of each intervention, including the per\u2010minute price of the endoscopy and operating room (OR), considering personnel, construction, inventory and overhead costs. Other in\u2010hospital costs were calculated using insurance claim data. Effectiveness was displayed as quality\u2010adjusted life years (QALY). Bootstrapping was performed to estimate uncertainty.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The calculated per\u2010minute price for the endoscopy room was \u20ac8.64 (US $9.34). The per\u2010minute price for an OR was \u20ac11.78 (US $12.74). The mean intervention costs were estimated at \u20ac4405.40 (US $4762.68) for EUS\u2010GE and \u20ac3393.71 (US $3668.93) for SGJ. Mean total in\u2010hospital costs were lower following EUS\u2010GE (\u20ac5172 [US $5591]) than after SGJ (\u20ac10,458 [US $11,306]), mainly due to a shorter length of hospital stay following EUS\u2010GE. Bootstrapping showed that 99.9% of iterations resulted in lower costs for EUS\u2010GE. Mean difference in 1\u2010month QALY contribution was 0.004 in favor of EUS\u2010GE. Most iterations fall within the bottom right quadrant (95.6%) of the cost\u2010effectiveness plane, indicating lower costs and improved QALY contribution for EUS\u2010GE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this study, EUS\u2010GE was more cost effective than SGJ. The additional intervention costs were clearly outweighed by a decrease in in\u2010hospital costs after the procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70220","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:50:37Z","timestamp":1780681837000},"source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Ultrasonography\u2010Guided Gastroenterostomy Is More Cost Effective Than Surgical Gastrojejunostomy: A Health\u2010Economic Evaluation Alongside a Randomized Trial"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-0715","authenticated-orcid":false,"given":"Yorick L.","family":"van de Pavert","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5558-4583","authenticated-orcid":false,"given":"Kirsten","family":"Opmeer","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2650-9350","authenticated-orcid":false,"given":"Marc G.","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, and Cancer Center Amsterdam Amsterdam UMC Location University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-9174","authenticated-orcid":false,"given":"Rina","family":"Bijlsma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Martini Hospital  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieke C.","family":"Booij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-9158","authenticated-orcid":false,"given":"Jurjen J.","family":"Boonstra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-5825","authenticated-orcid":false,"given":"Judith","family":"Boot","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-5499","authenticated-orcid":false,"given":"Marco J.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9605-6831","authenticated-orcid":false,"given":"Olivier R.","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Surgery, and Cancer Center Amsterdam Amsterdam UMC Location University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6323-6342","authenticated-orcid":false,"given":"Freek","family":"Daams","sequence":"additional","affiliation":[{"name":"Department of Surgery, and Cancer Center Amsterdam Amsterdam UMC Location Vrije Universiteit  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J. M.","family":"Derksen","sequence":"additional","affiliation":[{"name":"Department of Surgery Regional Academic Cancer Center Utrecht St Antonius Hospital Nieuwegein and University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2382-0672","authenticated-orcid":false,"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, and Cancer Center Amsterdam Amsterdam UMC Location University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-3561","authenticated-orcid":false,"given":"Janine B.","family":"Kastelijn","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6973","authenticated-orcid":false,"given":"Bas Groot","family":"Koerkamp","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-3923","authenticated-orcid":false,"given":"Jeroen","family":"Hagendoorn","sequence":"additional","affiliation":[{"name":"Department of Surgery Regional Academic Cancer Center Utrecht St Antonius Hospital Nieuwegein and University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-0079","authenticated-orcid":false,"given":"Jeanin E.","family":"van Hooft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-0668","authenticated-orcid":false,"given":"Akin","family":"Inderson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5455-5242","authenticated-orcid":false,"given":"Willem J.","family":"Lammers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7515-9276","authenticated-orcid":false,"given":"Daan J.","family":"Lips","sequence":"additional","affiliation":[{"name":"Department of Surgery Medisch Spectrum Twente  Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3649-8504","authenticated-orcid":false,"given":"J. 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