A single-centre prospective cohort of 152 patients with unresectable malignant gastric-outlet obstruction compared endoscopic stenting (76) with EUS-guided gastroenterostomy (76). EUS-GE was associated with fewer reinterventions, longer patency and better oral-intake scores, with similar success and adverse events, but treatment was not randomised.
Key findings
- After a median 121-day follow-up, EUS-GE had an adjusted reintervention hazard ratio of 0.22 (p
Why this matters globally
The findings add evidence that EUS-GE may provide more durable bypass than a stent vulnerable to tumour ingrowth, especially when survival allows benefit, but expertise and device access vary widely.
Thai researcher contribution
The senior author holds affiliations with Chulalongkorn University and National Taiwan University. The cohort was Taiwanese, representing Thai-affiliated collaboration rather than Thai patient data.
Limitations to consider
The non-randomised expert single-centre design is vulnerable to treatment-selection bias, residual confounding and learning curves. Death limits follow-up, and results may not generalise to lower-volume centres.