{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:42:38Z","timestamp":1791639758091,"version":"4.3.4"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Gastric outlet obstruction (GOO) is traditionally managed with surgical gastroenterostomy (surgical-GE) and enteral stenting (ES). Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is now a third option. Large studies assessing their relative risks and benefits with adequate follow-up are lacking. We conducted a comparative analysis of patients who underwent EUS-GE, ES, or surgical-GE for GOO.<\/jats:p><jats:p>\n          Patients and methods\u2002In this retrospective comparative cohort study, consecutive patients presenting with GOO who underwent EUS-GE, ES, or surgical-GE at two academic institutions were reviewed and independently cross-edited to ensure accurate reporting. The primary outcome was need for reintervention. Secondary outcomes were technical and clinical success, length of hospital stay (LOS), and adverse events (AEs). <\/jats:p><jats:p>\n          Results\u2002A total of 436 patients (232 EUS-GE, 131 ES, 73 surgical-GE) were included. The median duration of follow-up of the entire cohort was 185.5 days (interquartile range 55.25\u2013454.25 days). The rate of reintervention in the EUS-GE group was lower than in the ES and surgical-GE groups (0.9\u200a%, 12.2\u200a%, and 13.7\u200a%, P\u200a&lt;\u200a0.0001). Technical success was achieved in 98.3\u200a%, 99.2\u200a%, and 100\u200a% (P\u200a=\u200a0.58), and clinical success was achieved in 98.3\u200a%, 91.6\u200a%, and 90.4\u200a% (P\u200a&lt;\u200a0.0001) in the EUS-GE, ES, and surgical-GE groups, respectively. The EUS-GE group had a shorter LOS (2 days vs. 3 days vs. 5 days, P\u200a&lt;\u200a0.0001) and a lower AE rate than the ES and surgical-GE groups (8.6\u200a% vs. 38.9\u200a% vs. 27.4\u200a%, P\u200a&lt;\u200a0.0001). <\/jats:p><jats:p>\n          Conclusion\u2002This large cohort study demonstrates the safety and palliation durability of EUS-GE as an alternative strategy for GOO palliation in select patients.<\/jats:p>","DOI":"10.1055\/a-1976-2279","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T23:49:55Z","timestamp":1668124195000},"page":"E60-E66","source":"Crossref","is-referenced-by-count":39,"title":["Endoscopic ultrasound-guided gastroenterostomy for the management of gastric outlet obstruction: A large comparative study with long-term follow-up"],"prefix":"10.1055","volume":"11","author":[{"given":"Veeravich","family":"Jaruvongvanich","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tala","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barham K.","family":"Abu Dayyeh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Chandrasekhara","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Law","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Storm","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil B.","family":"Marya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University of Massachusetts Medical School, Worcester, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Abboud","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabih","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Matar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babusai","family":"Rapaka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navtej","family":"Buttar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Truty","sequence":"additional","affiliation":[{"name":"Division of Surgery, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maridi","family":"Aerts","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology-Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouredin","family":"Messaoudi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rastislav","family":"Kunda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"ref1","first-page":"1679","article-title":"Etiology of gastric outlet obstruction","volume":"91","author":"A Chowdhury","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3949\/ccjm.86a.18035","article-title":"Gastric outlet obstruction: A red flag, potentially manageable","volume":"86","author":"A H Koop","year":"2019","journal-title":"Cleve Clin J Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.amjsurg.2008.09.030","article-title":"A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction","volume":"198","author":"C Schmidt","year":"2009","journal-title":"Am J Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00464-011-1870-3","article-title":"Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction","volume":"26","author":"M D Chandrasegaram","year":"2012","journal-title":"Surg Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"4217","DOI":"10.1007\/s00464-017-5480-6","article-title":"Palliative gastrojejunostomy versus endoscopic stent placement for gastric outlet obstruction in patients with unresectable gastric cancer: a propensity score-matched analysis","volume":"31","author":"S H Jang","year":"2017","journal-title":"Surg Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1007\/s00464-012-2712-7","article-title":"Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction","volume":"27","author":"M Khashab","year":"2013","journal-title":"Surg Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"3153","DOI":"10.1007\/s00464-019-06955-z","article-title":"Palliative surgical bypass is superior to palliative endoscopic stenting in patients with malignant gastric outlet obstruction: systematic review and meta-analysis","volume":"33","author":"I Mintziras","year":"2019","journal-title":"Surg Endosc"},{"key":"ref8","first-page":"92","article-title":"Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction-a systematic review and meta-analysis of randomized and non-randomized trials","volume":"5","author":"V Nagaraja","year":"2014","journal-title":"J Gastrointest Oncol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"3114","DOI":"10.1007\/s00464-012-2301-9","article-title":"Stenting versus gastrojejunostomy for management of malignant gastric outlet obstruction: comparison of clinical outcomes and costs","volume":"26","author":"A Roy","year":"2012","journal-title":"Surg Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1097\/MOG.0000000000000389","article-title":"Endoscopic gastroenterostomy: techniques and review","volume":"33","author":"S Irani","year":"2017","journal-title":"Curr Opin Gastroenterol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1111\/den.12794","article-title":"Technical review of endoscopic ultrasonography-guided gastroenterostomy in 2017","volume":"29","author":"T Itoi","year":"2017","journal-title":"Dig Endosc"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"E144","DOI":"10.1055\/a-0799-9939","article-title":"Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction","volume":"7","author":"T Kerdsirichairat","year":"2019","journal-title":"Endosc Int Open"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"E1474","DOI":"10.1055\/a-0996-8178","article-title":"Efficacy and safety of EUS-guided gastroenterostomy for benign and malignant gastric outlet obstruction: a systematic review and meta-analysis","volume":"7","author":"T R McCarty","year":"2019","journal-title":"Endosc Int Open"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"E276","DOI":"10.1055\/s-0042-101789","article-title":"Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience","volume":"4","author":"A Tyberg","year":"2016","journal-title":"Endosc Int Open"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1055\/a-1708-0037","article-title":"Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy for the palliation of gastric outlet obstruction in patients with peritoneal carcinomatosis","volume":"54","author":"A Abbas","year":"2022","journal-title":"Endoscopy"},{"key":"ref16","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":"ref17","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":"ref18","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":"ref19","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":"ref20","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":"ref21","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1055\/a-1782-7568","article-title":"Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison","volume":"54","author":"R LJ van Wanrooij","year":"2022","journal-title":"Endoscopy"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"AB291","DOI":"10.1016\/j.gie.2019.03.1175","article-title":"Single center comparative study of endoscopic gastrojejunostomy versus surgical gastrojejunostomy for malignant gastric outlet obstruction","volume":"89","author":"J L Widmer","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref23","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":"ref24","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1136\/gutjnl-2015-310348","article-title":"Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction","volume":"65","author":"T Itoi","year":"2016","journal-title":"Gut"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4293\/108680811X13022985132074","article-title":"Laparoscopic gastrojejunostomy for the treatment of gastric outlet obstruction","volume":"15","author":"L P Zhang","year":"2011","journal-title":"JSLS"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.gie.2015.08.003","article-title":"A novel technique for salvaging a dislodged lumen-apposing metal stent during creation of an endoscopic gastrojejunostomy","volume":"83","author":"A Tyberg","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"E670","DOI":"10.1055\/a-1797-9318","article-title":"Efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy in patients with malignant gastric outlet obstruction and ascites","volume":"10","author":"T Mahmoud","year":"2022","journal-title":"Endosc Int Open"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1976-2279.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T23:58:26Z","timestamp":1673654306000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1976-2279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,10]]},"references-count":27,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,1,4]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1976-2279","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,10]]},"published":{"date-parts":[[2022,11,10]]}}}