The aim of this article is to review the different treatment options for malignant gastric outlet obstruction (GOO) and compare their safety and efficacy. We describe the history and evolution of gastrojejunostomy (GJ), endoscopic stenting and endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) and analyze the current evidence regarding these three methods available in the literature, comparing their applicability, safety, complications and cost when used for the treatment of malignant GOO. We conclude that given the benefits of endoscopic techniques and the ability to place a stent away from the tumor, EUS-GE is a promising technique that may yield an efficacy similar to that of surgical GJ and duodenal stenting, with lower reintervention rates and fewer adverse events.

中文翻译：

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不可切除恶性肿瘤中胃出口梗阻的优化管理。

本文的目的是回顾恶性胃出口梗阻（GOO）的不同治疗方案，并比较它们的安全性和有效性。我们描述了胃空肠造口术 (GJ)、内镜支架置入术和内镜超声引导下胃肠造口术 (EUS-GE) 的历史和演变，并分析了文献中关于这三种方法的现有证据，比较了它们在使用时的适用性、安全性、并发症和成本用于治疗恶性GOO。我们得出的结论是，鉴于内窥镜技术的优势和将支架远离肿瘤的能力，EUS-GE 是一种很有前途的技术，可能会产生与手术 GJ 和十二指肠支架相似的疗效，并且具有较低的再介入率和较少的不良反应事件。