Gut Liver.  2022 Sep;16(5):667-675. 10.5009/gnl210327.

Gastric Outlet Obstruction: Current Status and Future Directions

Affiliations
  • 1Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
  • 2Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands

Abstract

Gastric outlet obstruction (GOO) is a relatively common condition in which mechanical obstruction of the pylorus, distal stomach, or duodenum causes severe symptoms such as nausea, vomiting, abdominal pain, and early satiety. Its etiology includes both benign and malignant disorders. Currently, GOO has many treatment options, including initial conservative therapeutic protocols and more invasive procedures, such as surgical gastroenterostomy, stent placement and, the most recently implemented procedure, endoscopic ultrasound-guided gastroenterostomy (EUSGE). Each procedure has its merits, with surgery often prevailing in patients with longer life expectancy and stents being used most often in patients with malignant gastric outlet stenosis. The newly developed EUS-GE combines the immediate effect of stents and the long-term efficacy of gastroenterostomy. However, this novel method is a technically demanding process that requires expert experience and special facilities. Thus, the true clinical effectiveness, as well as the duration of the effects of EUS-GE, still need to be determined.

Keyword

Gastric outlet obstruction; Gastric outlet stenosis; Gastroenterostomy; Self expandable metal stent; Endoscopic ultrasound-guided gastroenterostomy
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