Randomized trial compares patient outcomes of duodenal and jejunal gastroenterostomy in gastric outlet obstruction, suggesting both methods are effective.
Background and Aims: EUS-guided gastroenterostomy (EUS-GE) is an effective option to palliate symptoms of gastric outlet obstruction (GOO). While the jejunum is conventionally targeted (EUS-GJ), targeting the duodenum (EUS-GD) may offer clinical advantages. Outcomes were compared for EUS-GJ and EUS-GD. Methods: Adult patients who underwent EUS-GE for GOO between 2020-2024 were included and categorized as an EUS-GD if the stent entered the transverse or ascending duodenum or an EUS-GJ if stent entered more distally. The primary outcome was clinical success (soft diet tolerance at 7 days). Secondary outcomes included adverse events (AEs), stent misdeployment, and unplanned endoscopic reintervention. Baseline demographic variables and outcomes were compared with statistical significance at P<0.05. Results: Of the 139 included patients (median age 67 years (IQR 61-74); 41% female), 105 underwent EUS-GJ and 34 underwent EUS-GD. Clinical success was 98% for EUS-GJ and 94% for EUS-GD (p=0.25). The misdeployment rate was 7% for EUS-GJ and 0% for EUS-GD (p=0.19). The AE rate was 22% for EUS-GJ and 12% for EUS-GD (p=0.23). There were no significant differences for stent obstruction (EUS-GJ 12% vs. EUS-GD 6%), bleeding (2% vs. 6%), perforation (4% vs. 0%), stent migration (1% vs. 0%), infection (3% vs. 0%), and unplanned reintervention (14% vs. 9%). Conclusion: Both EUS-GJ and EUS-GD demonstrate high clinical success with no significant differences in adverse event rates. These data can support intraprocedural decision making for endoscopists performing EUS-GE.
No takes yet. Share an insight, caveat, or question.
Khan et al. (2026) studied this question.