Endoscopic Gastroenterostomy Versus Surgical Gastrojejunostomy
Endoscopic Gastroenterostomy Versus Surgical Gastrojejunostomy
Recent comparative data suggest that EUS gastroenterostomy offers more durable patency than enteral stents for treatment of malignant GOO, leading some endoscopists to suggest that EUS gastroenterostomy should be the preferred endoscopic treatment approach.
EUS gastroenterostomy and surgical gastrojejunostomy have been compared in retrospective cohort analysis, suggesting a high technical success rate a shorter hospital length of stay for the endoscopic approach \[4\]. Comparison of these techniques has not been reported in controlled prospective fashion. A prospective trial is necessary in order to define the optimal interventional management option for treatment of malignant GOO in the context of the contemporary and rapidly evolved range of available endoscopic and surgical treatment options.
EUS gastroenterostomy and surgical gastrojejunostomy have been compared in retrospective cohort analysis, suggesting a high technical success rate a shorter hospital length of stay for the endoscopic approach \[4\]. Comparison of these techniques has not been reported in controlled prospective fashion. A prospective trial is necessary in order to define the optimal interventional management option for treatment of malignant GOO in the context of the contemporary and rapidly evolved range of available endoscopic and surgical treatment options.
Gastrointestinal
N/A
Adults
Not Available
Not Available
Yachimski, Patrick
Local
Vanderbilt University
03-18-2025
Eligibility
18 Years and older
ALL
false
Inclusion Criteria:
Age 18 years or older
Able to provide informed consent
Biopsy-proven cancer
Cancer without surgical resection as a curative treatment option
Clinical and radiographic presentation consistent with primary or metastatic tumor causing foregut obstruction at the level of the pylorus and/or duodenum
Exclusion Criteria:
Age 18 years
Pregnancy
Unable to provide informed consent
White Blood Count 3,000
Absolute Neutrophil Count 1,500
International normalized ratio > 1.6
Platelet count 100,000
Cancer with surgical resection as a curative treatment option
Surgically altered foregut anatomy
Multifocal intestinal obstruction
Abdominal ascites prohibitive of surgical candidacy
Abdominal wall mesh prohibitive of surgical candidacy
Child's Class B or C cirrhosis
Gastroesophageal varices or known portal hypertension
Body mass index >40
Age 18 years or older
Able to provide informed consent
Biopsy-proven cancer
Cancer without surgical resection as a curative treatment option
Clinical and radiographic presentation consistent with primary or metastatic tumor causing foregut obstruction at the level of the pylorus and/or duodenum
Exclusion Criteria:
Age 18 years
Pregnancy
Unable to provide informed consent
White Blood Count 3,000
Absolute Neutrophil Count 1,500
International normalized ratio > 1.6
Platelet count 100,000
Cancer with surgical resection as a curative treatment option
Surgically altered foregut anatomy
Multifocal intestinal obstruction
Abdominal ascites prohibitive of surgical candidacy
Abdominal wall mesh prohibitive of surgical candidacy
Child's Class B or C cirrhosis
Gastroesophageal varices or known portal hypertension
Body mass index >40
