Golikov Edwin, Widmer Jessica
Department of Gastroenterology & Hepatology, NYU Langone Long Island Hospital, Mineola, NY, USA.
Transl Gastroenterol Hepatol. 2025 Jan 17;10:13. doi: 10.21037/tgh-23-51. eCollection 2025.
Gastric outlet obstruction (GOO) occurs due to anatomic blockage of the stomach or duodenum. GOO typically manifests with symptoms such as early satiety, nausea, vomiting, and weight loss, due to either underlying benign or malignant causes. Historically, the gold standard for managing GOO has been surgical gastrojejunostomy. However, this approach comes with considerable drawbacks including prolonged recovery times and the necessity for suitable surgical candidates. Endoscopically placed self-expanding metal stents emerged as a notable advancement in palliating symptoms associated with GOO. However, their long-term efficacy is hindered by the frequent occurrence of stent occlusion, necessitating the need for further intervention. Most recently, endoscopic ultrasound guided gastroenterostomy (EUS-GE) using lumen-apposing metal stents has been described with promising technical and clinical success rates. The advent of EUS-GE heralds a significant stride forward in the management of GOO, offering a less invasive yet effective alternative to conventional surgical approaches. EUS-GE has been associated with lower adverse events as compared with surgical gastrojejunostomy and lower recurrence and reintervention rates compared with enteral stenting. The advent of EUS-GE heralds a significant stride forward in the management of GOO, offering a less invasive yet effective alternative to conventional surgical approaches. EUS-GE is a promising evolving technique for treating GOO, and ongoing studies are necessary to validate its use in both benign and malignant GOO.
胃出口梗阻（GOO）是由于胃或十二指肠的解剖性阻塞所致。GOO通常表现为早饱、恶心、呕吐和体重减轻等症状，其病因可为良性或恶性。历史上，治疗GOO的金标准一直是外科胃空肠吻合术。然而，这种方法存在相当多的缺点，包括恢复时间长以及需要合适的手术候选者。内镜下放置的自膨式金属支架是缓解与GOO相关症状的一项显著进展。然而，它们的长期疗效受到支架闭塞频繁发生的阻碍，需要进一步干预。最近，使用管腔贴附金属支架的内镜超声引导下胃肠吻合术（EUS-GE）已被报道，其技术成功率和临床成功率都很可观。EUS-GE的出现标志着GOO治疗取得了重大进展，为传统手术方法提供了一种侵入性较小但有效的替代方案。与外科胃空肠吻合术相比，EUS-GE的不良事件较少，与肠内支架置入术相比，复发率和再次干预率较低。EUS-GE的出现标志着GOO治疗取得了重大进展，为传统手术方法提供了一种侵入性较小但有效的替代方案。EUS-GE是一种治疗GOO的有前景的新兴技术，需要进行持续研究以验证其在良性和恶性GOO中的应用。
