Antonini F, Rizzo GEM, Fuccio L, Tarantino I. Malignant gastric outlet obstruction: The emerging role of endoscopic ultrasound-guided gastroenterostomy. World J Gastrointest Endosc 2025; 17(8): 110301 [DOI: 10.4253/wjge.v17.i8.110301]
Corresponding Author of This Article
Filippo Antonini, MD, Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Via Augusto Murri 1, Ascoli Piceno 63100, Marche, Italy. filippore@yahoo.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2025; 17(8): 110301 Published online Aug 16, 2025. doi: 10.4253/wjge.v17.i8.110301
Malignant gastric outlet obstruction: The emerging role of endoscopic ultrasound-guided gastroenterostomy
Filippo Antonini, Giacomo Emanuele Maria Rizzo, Lorenzo Fuccio, Ilaria Tarantino
Filippo Antonini, Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Ascoli Piceno 63100, Marche, Italy
Giacomo Emanuele Maria Rizzo, Ilaria Tarantino, Gastroenterology and Endoscopy Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo 90127, Sicilia, Italy
Lorenzo Fuccio, Department of Medical and Surgical Sciences, University of Bologna, Bologna 40138, Emilia-Romagna, Italy
Author contributions: Antonini F wrote the original draft and contributed to conceptualization and reviewing; Rizzo GEM and Fuccio L contributed to writing, reviewing and editing; Tarantino I participated in drafting the manuscript and supervised the manuscript preparation; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Filippo Antonini, MD, Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Via Augusto Murri 1, Ascoli Piceno 63100, Marche, Italy. filippore@yahoo.it
Received: June 4, 2025 Revised: June 27, 2025 Accepted: July 25, 2025 Published online: August 16, 2025 Processing time: 72 Days and 10.9 Hours
Abstract
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is emerging as a preferred approach for managing malignant gastric outlet obstruction. This technique offers a balance between the durability of surgical gastrojejunostomy (SGJ) and the minimally invasive nature of endoscopic methods. Compared to enteral stenting, EUS-GE shows superior outcomes, including higher long-term patency, lower symptom recurrence, and fewer reinterventions. It also demonstrates comparable or better efficacy than SGJ, with faster oral intake, shorter hospital stays, and reduced complications. However, EUS-GE requires specialized expertise, and long-term outcome data remain limited, so further research is needed to refine protocols and optimize patient selection.
Core Tip: Endoscopic ultrasound-guided gastroenterostomy is gaining clinical application in the palliative management of malignant gastric outlet obstruction. It provides superior long-term patency and lower reintervention rates compared to enteral stenting, while offering faster recovery and fewer complications than surgical gastrojejunostomy.
