ArticleTherapeutic advances in gastroenterology2026
Optimal endoscopic drainage strategy for concomitant biliary and gastric outlet obstruction: a multicenter retrospective study (ENDO-GOBO).
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- EUS-Guided Choledochoduodenostomy Versus Hepaticogastrostomy in Case of Concomitant Gastric Outlet Obstruction Treated by EUS-Guided Gastroenterostomy: A Systematic Review and Meta-Analysis.United European gastroenterology journal · 2026Pooled it
- Malignant Double Obstruction: How Can Advanced Endoscopy Help?Medicina (Kaunas, Lithuania) · 2026Review
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Authors and funding
31 authors.
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Abstract
Background: Concomitant malignant gastric outlet obstruction (MGOO) and malignant biliary obstruction (MBO) represent a challenging clinical scenario in which the optimal endoscopic strategy remains unclear. Objectives: This study aimed to compare real-life combinations of endoscopic ultrasound-guided biliary drainage-hepatogastrostomy (EUS-HGS) or choledochoduodenostomy (EUS-CDS)-with gastric outlet obstruction management-EUS-guided gastroenterostomy (EUS-GE) or enteral stenting (ES). Design: This was an international multicenter retrospective cohort study involving 11 tertiary centers (2017-2023). Methods: Consecutive patients with MBO and MGOO were included. All patients underwent both biliary and gastric outlet drainage using one of four combinations: EUS-HGS/EUS-GE, EUS-HGS/ES, EUS-CDS/EUS-GE, or EUS-CDS/ES. The primary outcome was stent dysfunction (biliary or digestive). Secondary outcomes included clinical success and adverse events. Results: A total of 159 patients were included (median age 70 years; pancreatic cancer 64.8%). Stent dysfunction occurred in 12.0% of patients treated with EUS-HGS/EUS-GE versus 26.6% with EUS-CDS/ES, 36.7% with EUS-HGS/ES, and 50.0% with EUS-CDS/EUS-GE ( Conclusion: In malignant obstruction, the choice of gastric outlet strategy appears to markedly influence biliary stent patency. When EUS-GE is performed, EUS-HGS may provide superior durability but at the cost of higher morbidity. Conversely, when ES is selected, EUS-CDS appears safer. These findings support a tailored approach integrating anatomical considerations and center expertise when selecting the optimal endoscopic double-drainage strategy.
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