{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:44:45Z","timestamp":1788993885551,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: EUS-guided gastroenterostomy (EUS-GE) is a novel and effective procedure for the management of malignant gastric outlet obstruction (GOO) with more durable results when compared to enteral stenting (ES). However, data comparing EUS-GE to ES in patients already treated with EUS-guided choledocoduodenostomy (EUS-CDS) for distal malignant biliary obstruction (DMBO) are lacking. We aimed to compare outcomes of EUS-GE and ES for the palliation of GOO in this specific population of patients. Methods: A multicenter, retrospective analysis of patients with DMBO treated by EUS-CDS and subsequent GOO treated by EUS-GE or ES from 2016 to 2021 was conducted. Primary outcomes were overall AEs rate and dysfunction of the EUS-CDS after GOO treatment. Secondary outcomes included clinical success, technical success, procedure duration, length of hospital stay and relapse of GOO symptoms. Results: A total of 77 consecutive patients were included in the study: 25 patients underwent EUS-GE and 52 underwent ES. AEs rate and patency outcomes of the EUS-CDS after GOO treatment were comparable between the two groups (12.5% vs. 17.3%; p = 0.74). No recurrence of GOO symptoms was registered in the EUS-GE group while 11.5% of ES patients had symptoms recurrence, even if not statistically significant (p = 0.16), after a mean follow-up period of 63.5 days. Conclusion: EUS-GE and ES are both effective and safe for the palliation of GOO in patients already treated by EUS-CDS for DMBO with no difference in the biliary stent dysfunction rate and overall AEs. EUS-GE is associated with less recurrence of GOO symptoms.<\/jats:p>","DOI":"10.3390\/cancers16193375","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T06:27:31Z","timestamp":1727850451000},"page":"3375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Palliation of Gastric Outlet Obstruction in Case of Biliary Obstruction\u2014A Retrospective, Multicenter Study: The B-GOOD Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0485-4903","authenticated-orcid":false,"given":"Alessandro","family":"Fugazza","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Andreozzi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-9684","authenticated-orcid":false,"given":"Cecilia","family":"Binda","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7724-7402","authenticated-orcid":false,"given":"Andrea","family":"Lisotti","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Hospital of Imola, University of Bologna, 40026 Imola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tarantino","sequence":"additional","affiliation":[{"name":"Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J.","family":"Vila","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Gastroenterology Department, Hospital Universitario de Navarra, 310000 Navarra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Robles Medranda","sequence":"additional","affiliation":[{"name":"Ecuadorian Institute of Digestive Diseases (IECED), Guayaquil 090505, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4397-4142","authenticated-orcid":false,"given":"Arnaldo","family":"Amato","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy and Gastroenterology Department, ASST Lecco, 23900 Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Larghi","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Perez Cuadrado Robles","sequence":"additional","affiliation":[{"name":"Georges Pompidou European Hospital-APHP, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Aragona","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Hospital of Piacenza, 29100 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Badas","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, University Hospital, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Barbera","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S. Agostino-Estense, 41126 Baggiovara di Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetto","family":"Mangiavillano","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, 21053 Castellanza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Crin\u00f2","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9910","authenticated-orcid":false,"given":"Carlo","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL Romagna, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4397-9314","authenticated-orcid":false,"given":"Pietro","family":"Fusaroli","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Hospital of Imola, University of Bologna, 40026 Imola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-0031","authenticated-orcid":false,"given":"Andrea","family":"Anderloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Foundation Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-9012","authenticated-orcid":false,"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"ref_1","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":"Ahmed","year":"2021","journal-title":"Clin. 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