Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips

Gastric outlet obstruction (GOO) is a condition characterized by a mechanical obstruction of the stomach or duodenum, caused by either benign or malignant disease. Traditionally, surgical gastrojejunostomy (SGJ) has been the standard treatment for malignant GOO and endoscopic stenting (ES) offers a...

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Main Authors: Chi-Ying Yang, Wen-Hsin Huang, Hsing-Hung Cheng
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2025-03-01
Series:Clinical Endoscopy
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Online Access:http://e-ce.org/upload/pdf/ce-2024-206.pdf
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author Chi-Ying Yang
Wen-Hsin Huang
Hsing-Hung Cheng
author_facet Chi-Ying Yang
Wen-Hsin Huang
Hsing-Hung Cheng
author_sort Chi-Ying Yang
collection DOAJ
description Gastric outlet obstruction (GOO) is a condition characterized by a mechanical obstruction of the stomach or duodenum, caused by either benign or malignant disease. Traditionally, surgical gastrojejunostomy (SGJ) has been the standard treatment for malignant GOO and endoscopic stenting (ES) offers a less invasive option, but it often requires repeat interventions. Recently, endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE), an innovative technique, has been applied as an alternative to SGJ and ES for GOO patients. Direct EUS-GE, device-associated EUS-GE, and EUS-guided double balloon-occluded gastrojejunostomy bypass are the most commonly used techniques with reported technical success rates ranging from 80% to 100%, and clinical success rates between 68% and 100%. Adverse event (AE) rates range from 0% to 28.2% and the stent misdeployment is the most common while other AEs include abdominal pain, bleeding, infection, peritonitis, bowel perforation, gastric leakage, and stent migration. It is clear that EUS-GE may achieve a similar clinical success to SGJ with fewer AEs and a shorter hospital stay. Compared to ES, EUS-GE showed higher clinical success, fewer stent obstructions, and lower reintervention rates.
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spelling doaj-art-638fc5acc4a843bb8cb626cb1b4b601e2025-08-20T03:05:45ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-03-0158220121710.5946/ce.2024.2067974Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tipsChi-Ying YangWen-Hsin HuangHsing-Hung ChengGastric outlet obstruction (GOO) is a condition characterized by a mechanical obstruction of the stomach or duodenum, caused by either benign or malignant disease. Traditionally, surgical gastrojejunostomy (SGJ) has been the standard treatment for malignant GOO and endoscopic stenting (ES) offers a less invasive option, but it often requires repeat interventions. Recently, endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE), an innovative technique, has been applied as an alternative to SGJ and ES for GOO patients. Direct EUS-GE, device-associated EUS-GE, and EUS-guided double balloon-occluded gastrojejunostomy bypass are the most commonly used techniques with reported technical success rates ranging from 80% to 100%, and clinical success rates between 68% and 100%. Adverse event (AE) rates range from 0% to 28.2% and the stent misdeployment is the most common while other AEs include abdominal pain, bleeding, infection, peritonitis, bowel perforation, gastric leakage, and stent migration. It is clear that EUS-GE may achieve a similar clinical success to SGJ with fewer AEs and a shorter hospital stay. Compared to ES, EUS-GE showed higher clinical success, fewer stent obstructions, and lower reintervention rates.http://e-ce.org/upload/pdf/ce-2024-206.pdfendosonographygastric outlet obstructiongastroenterostomyinterventional ultrasound
spellingShingle Chi-Ying Yang
Wen-Hsin Huang
Hsing-Hung Cheng
Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
Clinical Endoscopy
endosonography
gastric outlet obstruction
gastroenterostomy
interventional ultrasound
title Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
title_full Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
title_fullStr Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
title_full_unstemmed Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
title_short Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
title_sort endoscopic ultrasound guided gastroenterostomy with focus on technique and practical tips
topic endosonography
gastric outlet obstruction
gastroenterostomy
interventional ultrasound
url http://e-ce.org/upload/pdf/ce-2024-206.pdf
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AT wenhsinhuang endoscopicultrasoundguidedgastroenterostomywithfocusontechniqueandpracticaltips
AT hsinghungcheng endoscopicultrasoundguidedgastroenterostomywithfocusontechniqueandpracticaltips