Endoscopic Management of Malignant Gastric Outlet Obstruction
Summary
Malignant gastric outlet obstruction (MGOO) arises when neoplastic lesions in the pyloric region, distal stomach or duodenum impede gastric emptying, leading to nausea, vomiting, abdominal discomfort and nutritional compromise. Endoscopic approaches aim to restore luminal patency with minimal invasiveness, rapid recovery and palliative intent. Traditional endoscopic palliation utilises self-expandable metallic stents (SEMS) to bridge the obstructive segment, offering immediate relief of obstructive symptoms. However, tumour ingrowth, stent migration and limited patency have prompted innovations. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) employs real-time ultrasound to create a fistula between the stomach and jejunum using lumen-apposing metal stents (LAMS). This technique merges the durability of surgical bypass with the rapid clinical improvement of stenting, reducing stent dysfunction and potentially enhancing nutritional intake. Moreover, refinements in stent design—such as partially covered versus uncovered configurations and tailored stent shapes—have sought to balance patency, migration risk and tissue overgrowth. Optimal patient selection remains paramount; factors such as performance status, life expectancy, tumour burden and comorbidities inform the choice between enteral stenting, EUS-GE or surgical gastrojejunostomy. As expertise in advanced endoscopy expands, endoscopic management is increasingly positioned as a frontline palliative modality with global applicability and potential survival and quality-of-life benefits.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Endoscopic Management of Malignant Gastric Outlet Obstruction publication trend
The graph below shows the total number of articles in endoscopic management of malignant gastric outlet obstruction across all publications each year (not limited to Nature Index journals).
Technical terms
Malignant gastric outlet obstruction (MGOO): Tumour-induced blockage of the distal stomach or duodenum impairing gastric emptying.
Self-expandable metallic stent (SEMS): A mesh tubular device that expands radially to maintain luminal patency in obstructed gastrointestinal segments.
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE): A minimally invasive technique using ultrasound to guide the deployment of a stent between stomach and jejunum to bypass obstruction.
Lumen-apposing metal stent (LAMS): A specialised fully covered stent with flanged ends designed to anchor two adjacent luminal walls, facilitating secure anastomosis.
References
- Revealing Insights: A Comprehensive Overview of Gastric Outlet Obstruction Management, with Special Emphasis on EUS-Guided Gastroenterostomy. Medical Sciences (2024).
- Partially covered versus uncovered pyloro‐duodenal stents for unresectable malignant gastric outlet obstruction: Randomized controlled study. Digestive Endoscopy (2023).
- Endoscopic Ultrasound-Guided Gastroenterostomy versus Enteral Stenting for Malignant Gastric Outlet Obstruction: A Retrospective Propensity Score-Matched Study. Cancers (2024).
- Endoscopic ultrasound guided gastrojejunostomy in the treatment of gastric outlet obstruction: multi-centre experience from the United Kingdom. Surgical Endoscopy (2022).
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.