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Copyright ©The Author(s) 2021.
World J Gastrointest Oncol. Sep 15, 2021; 13(9): 1086-1098
Published online Sep 15, 2021. doi: 10.4251/wjgo.v13.i9.1086
Table 1 Causes of malignant gastric outlet obstruction
SitePathology
StomachDistal gastric cancer
Gastric lymphoma (e.g., MALT lymphoma)
Leiomyosarcoma
Gastrointestinal stromal tumor
Gastric neuroendocrine neoplasms
PancreasPancreatic adenocarcinoma
Cystic neoplasm of the pancreas
DuodenumDuodenal cancer
Leiomyosarcoma
Neoplasm of the ampulla
Gastrointestinal stromal tumor
Metastasis
Gallbladder and bile ductGallbladder and bile duct cancer
OtherRetroperitoneal lymphadenopathy (e.g., metastatic tumor, lymphoma)
Retroperitoneal sarcoma
Table 2 Treatment of mechanical malignant gastric outlet obstruction
CurativePalliation
SurgerySurgery (gastrojejunostomy)Surgical bypass
EndoscopyEndoscopic stenting
EUS-GE
Decompressive gastrostomy with or without feeding tube placement
Chemotherapy and radiotherapyChemotherapy (especially for GI lymphoma)Radiotherapy
Table 3 Summary of reports in the literature on endoscopic ultrasound-guided gastroenterostomy for malignant gastric outlet obstruction
Ref.
Nation
Study design
Population (n)
Techniques
Technical success (%)
Clinical success (%)
Adverse events(%)
Follow-up (wk)
GOO recurrence (%)
Khashab et al[28], 2015United StatesRetrospective multicenter10 (3 with malignant GOO)Direct (n = 1). Balloon-assisted (n = 9)901000210
Tyberg et al[29], 2016United StatesRetrospective multicenter26 (17 with malignant GOO)Direct (n = 3). Balloon-assisted (n = 13). NB catheter assisted (n = 3). Hybrid rendezvous (n = 5)928811.580
Itoi et al[30], 2016JapanProspective single center20EPASS909010140
Brewer Gutierrez et al[31], 2017United StatesRetrospective multicenter7Direct (n = 5). Balloon-assisted (n = 2)1001000150
Perez-Miranda et al[32], 2017United States and EuropeRetrospective multicenter25 (17 with malignant GOO)Direct (n = 6). Balloon-assisted (n = 9). NB catheter assisted (n = 3). Ultraslim-endoscope assisted (n = 7)88841280
Khashab et al[33], 2017United States and JapanRetrospective multicenter30Direct (n = 2). Balloon-assisted (n = 6). EPASS (n = 22)878716223
Chen et al[34], 2017United States and JapanRetrospective multicenter30Direct (n = 2). Balloon-assisted (n = 6). EPASS (n = 22)86.783.316.7144.3
Chen et al[35], 2018United States and EuropeRetrospective multicenter77 (52 with malignant GOO)Direct (n = 52). Balloon-assisted (n = 22)94.292.36.8177
90.990.99
Urrehman et al[36], 2018SingaporeProspective single center5Balloon-assisted EUS-GE100800--
Ge et al[37], 2019United StatesProspective single center22Direct EUS-GE10095.820.8244.5
Kerdsirichairat et al[38], 2019United StatesRetrospective multicenter57 (34 with malignant GOO)Direct EUS-GE9389.53.52815.1
Xu et al[39], 2020ChinaRetrospective single center36Double balloon-assisted EUS-GE10094.425132.7
Hu et al[40], 2020ChinaProspective single center9RPAT-assisted EUS-GE100100---
Kastelijn et al[41], 2020EuropeRetrospective multicenter45Direct (n = 36). Balloon-assisted (n = 9)86.773.326.7105.1
Wannhoff et al[42], 2020GermanyRetrospective single center35 (33 with malignant GOO)Direct (n = 22). Others (n = 12)8074.314.3810