Evidence map›Paper›PMID 40998416›Full record

Trial reportGut2025

Endoscopic or surgical gastroenterostomy for malignant gastric outlet obstruction: a randomised trial.

Ji Young Bang, Rajesh Puri, Sundeep Lakhtakia, Shyam Thakkar, Irving Waxman, Imran Siddiqui, Kristen Arnold, Adarsh Chaudhary, Shubham Mehta, Amanjeet Singh and 13 more

Registry-linked trialAbstract readEquivalence TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gut, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05548114 (Randomized Trial Comparing Endoscopic Ultrasound-guided Gastrojejunostomy and Surgical Gastrojejunostomy in Gastric Outlet Obstruction), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05548114 naactive not recruitingnot on this map

Randomized Trial Comparing Endoscopic Ultrasound-guided Gastrojejunostomy and Surgical Gastrojejunostomy in Gastric Outlet Obstruction

TypeinterventionalSponsorOrlando Health, Inc.Ran2022 to 2025Enrolled74ConditionsGastric Outlet ObstructionArmsEUS-guided gastrojejunostomy, Surgical gastrojejunostomy
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Updated Classification of EUS-Guided Gastroenterostomy Misdeployment.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Review
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
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  14. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Ji Young BangDigestive Health Institute, Orlando Health, Orlando, Florida, USA.ORCID http://orcid.org/0000-0001-9351-3267
Rajesh PuriGastroenterology, Medanta The Medicity, Gurugram, Haryana, India.
Sundeep LakhtakiaGastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.ORCID http://orcid.org/0000-0001-7562-8060
Shyam ThakkarGastroenterology, West Virginia University, Morgantown, West Virginia, USA.
Irving WaxmanGastroenterology, Rush University, Chicago, Illinois, USA.
Imran SiddiquiSurgical Oncology, Cancer Institute, Orlando Health, Orlando, Florida, USA.
Kristen ArnoldSurgical Oncology, Cancer Institute, Orlando Health, Orlando, Florida, USA.
Adarsh ChaudharySurgery, Medanta The Medicity, Gurugram, Haryana, India.
Shubham MehtaGastroenterology, Medanta The Medicity, Gurugram, Haryana, India.
Amanjeet SinghSurgery, Medanta The Medicity, Gurugram, Haryana, India.
Guduru Venkat RaoSurgery, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
Jahangeer BashaGastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.ORCID http://orcid.org/0000-0002-5621-6228
Rajesh GuptaGastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
Shreeyash ModakSurgery, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
Shailendra SinghGastroenterology, West Virginia University, Morgantown, West Virginia, USA.
Brian BooneSurgery, West Virginia University, Morgantown, West Virginia, USA.
Philip DautelUniversity Hospital Hamburg-Eppendorf Department of Interdisciplinary Endoscopy, Hamburg, Germany.
Matthew E B DixonSurgery, Rush University, Chicago, Illinois, USA.
Hyungjin Myra KimBiostatistics, University of Michigan-Ann Arbor, Ann Arbor, Michigan, USA.
Bryce SuttonDigestive Health Institute, Orlando Health, Orlando, Florida, USA.
Juan Pablo ArnolettiSurgical Oncology, Cancer Institute, Orlando Health, Orlando, Florida, USA.
Thomas RöschUniversity Hospital Hamburg-Eppendorf Department of Interdisciplinary Endoscopy, Hamburg, Germany.ORCID http://orcid.org/0000-0003-2270-2495
Shyam VaradarajuluDigestive Health Institute, Orlando Health, Orlando, Florida, USA svaradarajulu@yahoo.com.ORCID http://orcid.org/0000-0002-0047-0016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough surgical gastrojejunostomy (SGJ) is the standard method for palliation of gastric outlet obstruction (GOO), an endoscopic method-endoscopic ultrasound-guided gastroenterostomy (EUS-GE)-has been proposed as a novel, less invasive approach.

objectiveWe compared both methods to determine whether clinical outcomes for EUS-GE are superior to surgery.

designWe conducted a multicentre, randomised superiority trial of patients with malignant GOO to receive either EUS-GE or SGJ. Primary endpoint was composite measure, consisting of Gastric Outlet Obstruction Scoring System (GOOSS) score of 0 or 1 at hospital discharge, need for reinterventions or supplemental nutrition, or procedure-related adverse events during 6-month follow-up or until death. Secondary endpoints were time to solid diet, length of hospitalisation, health-related quality of life (HRQoL) and treatment costs.

results74 patients were randomly assigned to EUS-GE (38 patients) or SGJ (36 patients). Primary endpoint occurred in 7.9% of patients who received EUS-GE and 38.9% in SGJ (risk difference -31.0%, 95% CI -47.6% to -11.4%, p=0.002). EUS-GE was associated with more rapid advancement to solid diet (median 2 days (P25-P75, 2-3) vs 5 days (P25-P75, 3.5-9)), shorter hospitalisation (median 3 days (P25-P75, 3-6) vs 9 days (P25-P75, 6-12.5)), better HRQoL for physical (p=0.0016) and social functioning (p=0.011) and lower treatment costs (US$33 934 vs US$51 437, difference -US$17 503 (95% CI -US$27 807 to -US$7920)).

conclusionIn this randomised trial, EUS-GE was superior to SGJ with regards to oral intake, need for reinterventions or supplemental nutrition, length of hospitalisation, quality of life and treatment costs. TRIAL REGISTRATION NUMBER: NCT05548114.

Indexed as

Gastric Outlet ObstructionGastroenterostomyAgedEndosonographyFemaleHumansLength of StayMaleMiddle AgedPalliative CareQuality of LifeStomach NeoplasmsTreatment OutcomeUltrasonography, InterventionalENDOSCOPIC ULTRASONOGRAPHYGASTROINTESTINAL SURGERYINTESTINAL OBSTRUCTIONPANCREATIC CANCERRANDOMIZED CONTROLLED TRIAL

Identifiers

PMID40998416
PMCPMC12703243

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.