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Artif Intell Gastrointest Endosc. Jun 8, 2025; 6(2): 106600
Published online Jun 8, 2025. doi: 10.37126/aige.v6.i2.106600
Endoscopic ultrasound-guided gastroenterostomy: The new standard treatment of gastric outlet obstruction
Petko Ivanov Karagyozov, Daniel Kavrakov, Nadica Shumka
Petko Ivanov Karagyozov, Department of Interventional Gastroenterology, Clinic of Gastroenterology, Acibadem City Clinic Tokuda University Hospital, Sofia 1407, Bulgaria
Daniel Kavrakov, Nadica Shumka, Department of Interventional Gastroenterology, Clinic of Gastroenterology, Acibadem City Clinic University Hospital Tokuda, Sofia 1407, Bulgaria
Author contributions: Karagyozov P, Kavrakov D, and Shumka N contributed equally to the conception and design of this review; Karagyozov P drafted the manuscript; Kavrakov D and Shumka N contributed to the literature review and critical revision of the manuscript; All authors approved the final version of the manuscript
Conflict-of-interest statement: All authors declare no conflict 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: Petko Ivanov Karagyozov, MD, PhD, Associate Professor, FASGE, Department of Interventional Gastroenterology, Clinic of Gastroenterology, Acibadem City Clinic Tokuda University Hospital, 51B N. Vaptzarov Blvd, Sofia 1407, Bulgaria. petko.karagyozov@gmail.com
Received: March 3, 2025
Revised: April 2, 2025
Accepted: April 21, 2025
Published online: June 8, 2025
Processing time: 96 Days and 12.7 Hours
Core Tip

Core Tip: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a promising minimally invasive treatment for gastric outlet obstruction, challenging traditional surgical gastrojejunostomy and duodenal stenting. It offers rapid recovery, improved symptom relief, and reduced reintervention rates, particularly benefiting oncologic patients. Despite its advantages, EUS-GE remains technically complex, requiring refinement in technique, standardization, and training programs. Issues such as stent misdeployment, long-term outcomes, and best technical approaches remain unresolved. Further studies, including randomized trials, are needed to establish EUS-GE as the standard of care, optimize safety, and expand indications, including potential applications in bariatric endoscopy and gastroparesis management.