{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:00:17Z","timestamp":1792483217804,"version":"4.5.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Endoscopic duodenal stenting is the current standard treatment for malignant gastric outlet obstruction (GOO) in patients with limited life expectancy. However, duodenal stenting is prone to stent dysfunction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel technique with potentially superior stent patency. We compared clinical success, safety, and stent dysfunction of EUS-GE and duodenal stenting in patients with malignant GOO using propensity score matching.<\/jats:p><jats:p>\n          Methods\u2002This international, multicenter, retrospective study analyzed consecutive patients undergoing EUS-GE or duodenal stenting for GOO between 2015 and 2021 in three European centers. Primary outcomes were clinical success (GOO scoring system [GOOSS] \u2265\u200a2) and stent dysfunction (GOOSS \u2264\u200a1 after initial clinical success). A propensity score matching (1:1) analysis was performed using age, sex, underlying disease, disease stage, ascites, and peritoneal carcinomatosis as variables.<\/jats:p><jats:p>\n          Results\u2002214 patients underwent EUS-GE (n\u200a=\u200a107) or duodenal stenting (n\u200a=\u200a107). After propensity score matching, 176 patients were matched and compared. Technical success rates for EUS-GE and duodenal stenting were 94\u200a% (95\u200a%CI 89\u200a%\u201399\u200a%) vs. 98\u200a% (95\u200a%CI 95\u200a%\u2013100\u200a%), respectively (P\u200a=\u200a0.44). Clinical success rates were 91\u200a% (95\u200a%CI 85\u200a%\u201397\u200a%) vs. 75\u200a% (95\u200a%CI 66\u200a%\u201384\u200a%; P\u200a=\u200a0.008). Stent dysfunction occurred in 1\u200a% (95\u200a%CI 0\u20134\u200a%) vs. 26\u200a% (95\u200a%CI 15\u200a%\u201337\u200a%) of patients (P\u200a&lt;\u200a0.001). Adverse event rate was 10\u200a% (95\u200a%CI 4\u200a%\u201317\u200a%) vs. 21\u200a% (95\u200a%CI 12\u200a%\u201329\u200a%; P\u200a=\u200a0.09).<\/jats:p><jats:p>\n          Conclusion\u2002EUS-GE had higher clinical success and lower stent dysfunction, with similar safety, compared with duodenal stenting, suggesting that EUS-GE may be preferred over duodenal stenting in patients with malignant GOO.<\/jats:p>","DOI":"10.1055\/a-1782-7568","type":"journal-article","created":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T23:49:14Z","timestamp":1648165754000},"page":"1023-1031","source":"Crossref","is-referenced-by-count":103,"title":["Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison"],"prefix":"10.1055","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0477-4532","authenticated-orcid":false,"given":"Roy L. J.","family":"van Wanrooij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-1761","authenticated-orcid":false,"given":"Giuseppe","family":"Vanella","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute and University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2039-5022","authenticated-orcid":false,"given":"Michiel","family":"Bronswijk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium"},{"name":"Department of Gastroenterology and Hepatology, Imelda General Hospital, Bonheiden, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"de Gooyer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0842-7813","authenticated-orcid":false,"given":"Wim","family":"Laleman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"van Malenstein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Vito","family":"Mandarino","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute and University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Dell\u2019Anna","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute and University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo G.","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute and University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schalk W.","family":"van der Merwe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogier P.","family":"Voermans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1572-0241.2002.05391.x","article-title":"Malignant gastric outlet obstruction: bridging another divide","volume":"97","author":"D A Tendler","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"ref2","first-page":"6529563","article-title":"The predictive and prognostic factors in patients with gastric cancer accompanied by gastric outlet obstruction","volume":"2020","author":"H Zu","year":"2020","journal-title":"Gastroenterol Res Pract"},{"key":"ref3","first-page":"269","article-title":"Palliative management of malignant antro-pyloric strictures. Gastroenterostomy vs. endoscopic stenting. A randomized prospective trial","volume":"24","author":"E Fiori","year":"2004","journal-title":"Anticancer Res"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.gie.2009.09.042","article-title":"Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial","volume":"71","author":"S M Jeurnink","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00464-005-0130-9","article-title":"Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction","volume":"20","author":"S Mehta","year":"2006","journal-title":"Surg Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.cgh.2021.03.046","article-title":"AGA Clinical practice update on the optimal management of the malignant alimentary tract obstruction: expert review","volume":"19","author":"O Ahmed","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.cgh.2021.03.046","article-title":"AGA Clinical Practice Update on the Optimal Management of the Malignant Alimentary Tract Obstruction: Expert Review","volume":"19","author":"O Ahmed","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"12468","DOI":"10.3748\/wjg.v21.i43.12468","article-title":"Self-expandable metal stents for malignant gastric outlet obstruction: a pooled analysis of prospective literature","volume":"21","author":"E E van Halsema","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.gie.2021.04.006","article-title":"Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score-matched comparison (with video)","volume":"94","author":"M Bronswijk","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"E275","DOI":"10.1055\/s-0043-101695","article-title":"International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction","volume":"5","author":"M A Khashab","year":"2017","journal-title":"Endosc Int Open"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/MCG.0000000000000887","article-title":"EUS-guided gastrojejunostomy versus laparoscopic gastrojejunostomy: an international collaborative study","volume":"51","author":"M Perez-Miranda","year":"2017","journal-title":"J Clin Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"7058","DOI":"10.1007\/s00464-020-08221-z","article-title":"Endoscopic ultrasound-guided gastroenterostomy versus open surgical gastrojejunostomy: clinical outcomes and cost effectiveness analysis","volume":"35","author":"A Kouanda","year":"2021","journal-title":"Surg Endosc"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1007\/s00464-016-5311-1","article-title":"EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction","volume":"31","author":"Y I Chen","year":"2017","journal-title":"Surg Endosc"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"3404","DOI":"10.1007\/s00464-018-06636-3","article-title":"EUS-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction","volume":"33","author":"P S Ge","year":"2019","journal-title":"Surg Endosc"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1572-0241.2002.05423.x","article-title":"Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients","volume":"97","author":"D G Adler","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.gie.2009.10.027","article-title":"A lexicon for endoscopic adverse events: report of an ASGE workshop","volume":"71","author":"P B Cotton","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.vgie.2020.06.012","article-title":"EUS-guided gastroenterostomy: less is more! The wireless EUS-guided gastroenterostomy simplified technique","volume":"5","author":"M Bronswijk","year":"2020","journal-title":"VideoGIE"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"4165","DOI":"10.1007\/s00464-017-5471-7","article-title":"Predictors of stent dysfunction after self-expandable metal stent placement for malignant gastric outlet obstruction: tumor ingrowth in uncovered stents and migration of covered stents","volume":"31","author":"Y Hori","year":"2017","journal-title":"Surg Endosc"},{"key":"ref19","first-page":"275","article-title":"Predictors of self-expanding metallic stent dysfunction in malignant gastric outlet obstruction","volume":"85","author":"L S Suder-Castro","year":"2020","journal-title":"Rev Gastroenterol Mex (Engl Ed)"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1007\/s00464-020-07594-5","article-title":"Endoscopic gastrointestinal anastomoses with lumen-apposing metal stents: predictors of technical success","volume":"35","author":"A Wannhoff","year":"2021","journal-title":"Surg Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"E496","DOI":"10.1055\/a-1341-0788","article-title":"EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: systematic review and meta-analysis","volume":"9","author":"S Chandan","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1055\/a-1654-6914","article-title":"Clinical and technical outcomes of patients undergoing endoscopic ultrasound-guided gastroenterostomy using 20-mm vs. 15-mm lumen-apposing metal stents","author":"M Bejjani","year":"2021","journal-title":"Endoscopy"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.dld.2011.08.012","article-title":"Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: an international prospective multicentre registry","volume":"44","author":"G Costamagna","year":"2012","journal-title":"Dig Liver Dis"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1080\/00365520902929849","article-title":"Palliative treatment of malignant gastroduodenal obstruction with metallic stent: prospective comparison of covered and uncovered stents","volume":"44","author":"K M Lee","year":"2009","journal-title":"Scand J Gastroenterol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.gie.2013.06.032","article-title":"Endoscopic treatment of malignant gastric and duodenal strictures: a prospective, multicenter study","volume":"79","author":"A Tringali","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/1471-230X-14-170","article-title":"Covered versus uncovered self-expandable metallic stents for palliation of malignant gastric outlet obstruction: a systematic review and meta-analysis","volume":"14","author":"Y M Pan","year":"2014","journal-title":"BMC Gastroenterol"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/j.gie.2008.06.009","article-title":"Metallic stents for gastric outlet obstruction: reintervention rate is lower with uncovered versus covered stents, despite similar outcomes","volume":"69","author":"I Maetani","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.gie.2008.07.026","article-title":"Efficacy and safety of the new WallFlex enteral stent in palliative treatment of malignant gastric outlet obstruction (DUOFLEX study): a prospective multicenter study","volume":"69","author":"J E van Hooft","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"E1194","DOI":"10.1055\/a-1214-5659","article-title":"Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction","volume":"8","author":"J B Kastelijn","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.gie.2020.09.041","article-title":"Assessment of the learning curve for EUS-guided gastroenterostomy for a single operator","volume":"93","author":"M Jovani","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/a-1717-1391","article-title":"Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"54","author":"S W van der Merwe","year":"2022","journal-title":"Endoscopy"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1782-7568.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T15:08:00Z","timestamp":1666969680000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1782-7568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,24]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,10,27]]},"published-print":{"date-parts":[[2022,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1782-7568","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,24]]}}}