{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:19:57Z","timestamp":1792225197776,"version":"4.4.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background The optimal treatment for malignant gastric outlet obstruction (GOO) remains uncertain. This systematic review aimed to comprehensively investigate the efficacy and safety of four palliative treatments for malignant GOO: gastrojejunostomy, endoscopic ultrasound-guided gastroenterostomy (EUS-GE), stomach-partitioning gastrojejunostomy (PGJ), and endoscopic stenting.<\/jats:p><jats:p>\n            Methods We searched PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform for randomized controlled trials (RCTs) and cohort studies comparing the four treatments for malignant GOO. We included studies that reported at least one of the following clinical outcomes: clinical success, 30-day mortality, reintervention rate, or length of hospital stay. Evidence from RCTs and non-RCTs was na\u00efve combined to perform network meta-analysis through the frequentist approach using an inverse variance model. Treatments were ranked by P score.<\/jats:p><jats:p>\n            Results This network meta-analysis included 3617 patients from 4 RCTs, 4 prospective cohort studies, and 32 retrospective cohort studies. PGJ was the optimal approach in terms of clinical success and reintervention (P scores: 0.95 and 0.90, respectively). EUS-GE had the highest probability of being the optimal treatment in terms of 30-day mortality and complications (P scores: 0.82 and 0.99, respectively). Cluster ranking to combine the P scores for 30-day mortality and reintervention indicated the benefits of PGJ and EUS-GE (cophenetic correlation coefficient: 0.94; PGJ and EUS-GE were in the same cluster).<\/jats:p><jats:p>\n            Conclusion PGJ and EUS-GE are recommended for malignant GOO. PGJ could be the alternative choice in centers with limited resources or in patients who are unsuitable for EUS-GE.<\/jats:p>","DOI":"10.1055\/a-2309-7683","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:04:56Z","timestamp":1713571496000},"page":"780-789","source":"Crossref","is-referenced-by-count":18,"title":["Palliative procedures for malignant gastric outlet obstruction: a network meta-analysis"],"prefix":"10.1055","volume":"56","author":[{"given":"Khoi Van","family":"Tran","sequence":"additional","affiliation":[{"name":"International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan"},{"name":"Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen-Phong","family":"Vo","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Cho Ray Hospital, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung Song","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam"},{"name":"Intensive Care Unit Department, Children\u2019s Hospital 1, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhi Thi","family":"Vo","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi Bao Trang","family":"Thai","sequence":"additional","affiliation":[{"name":"International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu Anh","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El-Wui","family":"Loh","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan"},{"name":"Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-Wai","family":"Tam","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan"},{"name":"Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan"},{"name":"Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref1","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":"ref2","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.cgh.2018.10.042","article-title":"Superiority of gastrojejunostomy over endoscopic stenting for palliation of malignant gastric outlet obstruction","volume":"17","author":"S Jang","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/s0016-5107(04)02757-9","article-title":"Endoscopy or surgery for malignant GI outlet obstruction?","volume":"61","author":"M Del Piano","year":"2005","journal-title":"Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.amjsurg.2012.08.018","article-title":"Endoscopic stenting for gastric outlet obstruction in patients with unresectable antro pyloric cancer. 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