GIE Associate Editor, Dr. Fauze Maluf-Filho, highlights this article from the September issue “Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score–matched comparison” by Michiel Bronswijk, MD, et al.

In this observational, multicenter study, the authors compared the outcomes of EUS-guided gastroenterostomy versus the gold standard intervention, laparoscopic gastroenterostomy, for the treatment of gastric outlet obstruction (of malignant etiology in the majority of the cases). They found that technical and clinical success rates were similar between the groups of comparison. In addition, median time to oral intake and median hospital stay were significantly shorter in the EUS group overall, and severe adverse events rates were higher in the laparoscopic group.

The authors employed a statistical tool (propensity score matching) to reduce the bias of observational studies. In the absence of randomized clinical trials, this is the best available evidence suggesting that, in selected patients with malignant gastric outlet obstruction, EUS-guided gastroenterostomy may be a valid alternative to laparoscopic gastroenterostomy. In addition, the authors aimed to standardize a simplified technique of EUS-guided GE detailed in a nice supplementary video.

EUS-guided gastroenterostomy is a safe and effective technique to palliate symptoms in patients with malignant outlet obstruction. It has the potential to replace laparoscopic gastroenterostomy.

Read the article abstract here.

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