Stefanovic Sebastian, Draganov Peter V, Yang Dennis
Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana 1000, Slovenia.
Division of Gastroenterology, Hepatology, and Nutrition, University of Florida College of Medicine, Gainesville, FL 32608, United States.
World J Gastrointest Surg. 2021 Jul 27;13(7):620-632. doi: 10.4240/wjgs.v13.i7.620.
Gastric outlet obstruction (GOO) is a clinical syndrome secondary to luminal obstruction at the level of the stomach and/or duodenum. GOO can be caused by either benign or malignant etiologies, often resulting in early satiety, nausea, vomiting and poor oral intake. GOO is associated with decreased quality of life and has been shown to significantly impact survival in patients with advanced malignancies. Traditional treatment options for GOO can be broadly divided into surgical [surgical gastrojejunostomy (GJ)] and endoscopic interventions (dilation and/or placement of luminal self-expanding metal stents). While surgical GJ has been shown to provide a more lasting relief of symptoms when compared to luminal stenting, it has also been associated with a higher rate of adverse events. Furthermore, many patients with advanced metastatic disease are not good surgical candidates. More recently, endoscopic ultrasound (EUS)-guided GJ has emerged as a potential alternative to traditional surgical and endoscopic approaches. This review focuses on the new advances and technical aspects of EUS-GJ and clinical outcomes in the management of both benign and malignant disease.
胃出口梗阻（GOO）是一种继发于胃和/或十二指肠水平管腔梗阻的临床综合征。GOO可由良性或恶性病因引起，常导致早饱、恶心、呕吐及经口摄入量减少。GOO与生活质量下降相关，并已证明对晚期恶性肿瘤患者的生存有显著影响。GOO的传统治疗选择可大致分为手术治疗[外科胃空肠吻合术（GJ）]和内镜干预（扩张和/或放置腔内自膨式金属支架）。虽然与腔内支架置入相比，外科GJ已被证明能更持久地缓解症状，但它也与更高的不良事件发生率相关。此外，许多晚期转移性疾病患者并非手术的合适人选。最近，内镜超声（EUS）引导下的GJ已成为传统手术和内镜方法的一种潜在替代方案。本综述重点关注EUS-GJ在良性和恶性疾病管理中的新进展、技术方面及临床结果。
