This American Society for Gastrointestinal Endoscopy guideline provides evidence-based recommendations for the endoscopic management of gastric outlet obstruction (GOO). We applied the Grading of Recommendations, Assessment, Development and Evaluation methodology to address key clinical questions. These include the comparison of (1) surgical gastrojejunostomy to the placement of self-expandable metallic stents (SEMS) for malignant GOO, (2) covered versus uncovered SEMS for malignant GOO, and (3) endoscopic and surgical interventions for the management of benign GOO. Recommendations provided in this document were founded on the certainty of the evidence, balance of benefits and harms, considerations of patient and caregiver preferences, resource utilization, and cost-effectiveness.
Bibliographical noteFunding Information:
The following authors disclosed financial relationships: A. C. Storm: Consultant for Apollo Endosurgery US Inc, Endo-TAGSS, and Enterasense; data and safety monitoring support from Erbe USA Inc. and GI Dynamics. D. S. Fishman: Contributor payment support for intellectual property from UpToDate. M. A. Khashab: Consultant for BSCI, Olympus, and Medtronic. M. Al-Haddad: Research and teaching support from Boston Scientific. S. K. Amateau: Consultant for Boston Scientific Corporation, Cook Medical LLC, Endo-Therapeutics, Hemostasis LLC, Merit Medical Systems Inc, Olympus Corporation of the Americas, and STERIS Corporation. J. L. Buxbaum: Consultant for Boston Scientific Corporation, Eagle Pharmaceuticals, Inc, Cook Medical LLC, and Olympus America Inc; grant support from Medtronic USA, Inc and Olympus America Inc. C. J. DiMaio: Consultant for AbbVie, Boston Scientific Corporation, and Covidien. L. L. Fujii-Lau: Travel compensation from Ovesco. S. R. Gurudu: Research grant from Gilead Pharmaceuticals. L. H. Jamil: Consultant and speaker for Aries Pharmaceutical. M. S. Sawhney: Stockholder with Allurion Technology, Inc. N. C. Thosani: Consultant for Boston Scientific Corporation, Covidien, and Pentax of America, Inc. J. Yang: Consultant for Olympus. S. B. Wani: Consultant for Boston Scientific, Medtronic, and Interpace; advisory board member for Cernostics.
© 2021 American Society for Gastrointestinal Endoscopy
PubMed: MeSH publication types
- Practice Guideline