Background: Palliative treatment of malignant gastric outlet obstruction (GOO) is typically obtained by endoscopic placement of a duodenal self expandable metal stent (D-SEMS), with excellent results in the short-term, but with a high incidence of D-SEMS disfunction due to tumor overgrowth in the long-term. Whether endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) may be a better alternative for this type of patients remains to be proved. Aim: To compare the performance characteristics of EUS-GJ and D-SEMS for palliation of malignant GOO. Methods: Study period: 07/2017-11/2019. Inclusion criteria: Patients undergoing EUS-GJ (Group A) or D-SEMS (Group B) for palliative therapy of malignant GOO at 8 institutions. Exclusion criteria: 1.) EUS-GJ or D-SEMS performed by a non-malignant condition. Technique EUS-GJ: Nasobiliary tube for irrigation of jejunum+EUS-guided hot-axios. Outcomes: 1) Technical-success: successful hot-axios/D-SEMS placement; 2) Clinicalsuccess: ability to resume oral intake after endoscopic therapy; 3) Adverse events(AEs); 4) Long-term patency of stent. All attempts of EUS-GJ/D-SEMS performed
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