Objective:

To evaluate the efficacy and safety of endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) compared to surgical gastrojejunostomy (SGJ) and enteral stenting in patients with malignant gastric outlet obstruction (MGOO), focusing on primary outcomes such as stent failure rates and patient quality of life.

Key Findings:

• EUS-GE may reduce stent failure compared to traditional methods, potentially improving patient outcomes.
• SGJ is associated with lower rates of re-obstruction and longer intestinal patency, suggesting it may be more effective in certain patient populations.
• Enteral stenting provides rapid symptom relief but has limited long-term durability, indicating a need for careful patient selection.

Interpretation:

EUS-GE presents a promising alternative for palliation in MGOO, potentially offering benefits over traditional methods; however, further studies are essential to establish its superiority and long-term outcomes.

Limitations:

• Limited number of studies directly comparing EUS-GE with SGJ and enteral stenting, which may affect the robustness of conclusions.
• Variability in study designs and patient populations may limit the generalizability of the findings.

Conclusion:

EUS-GE may be a viable option for managing MGOO, warranting further investigation to clarify its role relative to established techniques and to enhance patient care.