• Alessandro Fugazza, Marta Andreozzi, Hamid Asadzadeh Aghdaei, Agustin Insausti, Marco Spadaccini, Matteo Colombo, Silvia Carrara, Maria Terrin, Alessandro De Marco, Gianluca Franchellucci, Kareem Khalaf, Pardis Ketabi Moghadam, Chiara Ferrari, Andrea Anderloni, Giovanni Capretti, Gennaro Nappo, Alessandro Zerbi, and Alessandro Repici.
• Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
• Medicina (Kaunas). 2024 Apr 16; 60 (4).

AbstractGastrojejunostomy is the principal method of palliation for unresectable malignant gastric outlet obstructions (GOO). Gastrojejunostomy was traditionally performed as a surgical procedure with an open approach butrecently, notable progress in the development of minimally invasive procedures such as laparoscopic gastrojejunostomies have emerged. Additionally, advancements in endoscopic techniques, including endoscopic stenting (ES) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE), are becoming more prominent. ES involves the placement of self-expandable metal stents (SEMS) to restore luminal patency. ES is commonly the first choice for patients deemed unfit for surgery or at high surgical risk. However, although ES leads to rapid improvement of symptoms, it carries limitations like higher stent dysfunction rates and the need for frequent re-interventions. Recently, EUS-GE has emerged as a potential alternative, combining the minimally invasive nature of the endoscopic approach with the long-lasting effects of a gastrojejunostomy. Having reviewed the advantages and disadvantages of these different techniques, this article aims to provide a comprehensive review regarding the management of unresectable malignant GOO.

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