GIE Senior Associate Editor Jennifer Maranki, MD, MSc, FASGE, highlights this article from the September issue: “EUS-guided gastroenterostomy for management of malignant gastric outlet obstruction: a prospective cohort study with matched comparison with enteral stenting” by Giuseppe Vanella, MD, et al.

This is a prospective registry study of patients undergoing EUS-guided gastroenterostomy (EUS-GE) for treatment of malignant gastric outlet obstruction compared with an enteral stenting subgroup that was matched by frailty scores and oncologic disease. Vanella et al studied 104 patents, with 70 undergoing EUS-GE. They reported technical and clinical success in 97.1% of patients, with adverse events occurring in 12.9% and symptom recurrence in 7.6% after a median follow-up of more than 100 days.

When compared with the enteral stenting group, the EUS-GE group had higher and faster clinical success, fewer recurrences, as well as a trend toward shorter chemotherapy resumption.

This is an important study because it provides prospective data to help guide our clinical decision-making. Unlike many retrospective studies, this cohort study showed a clear effort to obtain follow-up on these patients, providing a better assessment of how well this technique performs instead of relying only on immediate and technical success.

Although endoscopic stenting is technically less challenging and does not require the use of EUS, the impressive technical and clinical success rates, paired with an attractive safety profile, suggest that EUS-GE should be considered as first-line therapy in patients with favorable anatomy who have a reasonable life expectancy.

Graphical Abstract

Read the full article online.

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