EUS-guided gastroenterostomy for gastric outlet obstruction: a comprehensive meta-analysis

ObjectiveA comprehensive meta-analysis was performed to evaluate the efficacy and safety of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for benign and malignant gastric outlet obstruction (GOO).Material and methodsPubMed, Embase, Web of Science and Cochrane Library were searched to identify relevant studies. The primary outcomes evaluated technical success, clinical success, and adverse events (AEs).ResultsTwenty-six studies with 1493 patients were included in this meta-analysis. The pooled rates of technical success, clinical success, and overall AEs of EUS-GE were 94.0%, 89.9%, and 13.1%, respectively. Eight studies were included in the subgroup meta-analysis for comparative evaluation of EUS-GE and surgical gastroenterostomy (SGE), while seven studies were for EUS-GE and enteral stenting (ES). Compared with SGE, the pooled odds ratios (ORs) of technical success, clinical success, and overall AEs of EUS-GE were 0.17 (p = .003), 1.42 (p = .40), and 0.15 (p < .00001), respectively. When compared with ES, the above corresponding pooled ORs were 0.55 (p = .11), 2.64 (p < .0001), and 0.41 (p = .01), respectively.ConclusionAlthough it is technically challenging, this largest meta-analysis indicates that EUS-GE has comparable and high technical and clinical success rates and hence a very effective minimally invasive procedure for GOO.

Automated summary

A comprehensive meta-analysis was conducted to evaluate the efficacy and safety of EUS-GE for GOO. The results showed that EUS-GE had high technical and clinical success rates, making it a very effective minimally invasive procedure for GOO. Compared to SGE, EUS-GE had advantages in technical success and overall adverse events, while it was comparable in clinical success. Compared to ES, EUS-GE had advantages in clinical success and overall adverse events.