Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for gastric outlet obstruction: A systematic review, meta-analysis, and meta-regression

• Published in: Medicine (Baltimore) 2024-10, Vol.103 (40), p.e39948
• Main Authors: Jain, Hritvik, Dey, Debankur, Odat, Ramez M, Hussein, Ayham Mohammad, Abbasi, Haleema Qayyum, Madaan, Hritik, Goyal, Aman, Jain, Jyoti, Ahmed, Mushood, Marsool, Mohammed Dheyaa Marsool, Yadav, Rukesh
• Format: Article
• Language: English
• Subjects: Duodenum - surgery; Endosonography - methods; Gastric Outlet Obstruction - etiology; Gastric Outlet Obstruction - surgery; Gastroenterostomy - methods; Humans; Stents; Systematic Review and Meta-Analysis; Treatment Outcome; Ultrasonography, Interventional - methods
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000039948

Gastric outlet obstruction (GOO) refers to mechanical obstruction at the level of the gastric outlet and is associated with significantly impacted quality of life and mortality. Duodenal stenting (DS) offers a minimally invasive approach to managing GOO but is associated with a high risk of stent obstruction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel intervention that uses lumen-apposing metal stents to open the restricted lumen. The current evidence comparing EUS-GE to DS is limited and inconsistent. We conducted a systematic literature search on PubMed, Embase, Cochrane, Scopus, and clinicaltrials.gov to retrieve studies comparing EUS-GE to DS for GOO. Odds ratios (OR) and mean differences (MD) with their 95% confidence intervals (CI) were pooled using the DerSimonian-Laird inverse variance random-effects model. Statistical significance was set at P