Treatment of choice for malignant gastric outlet obstruction: More than clearing the road  

作　　者：Li Jiang Xiao-Ping Chen 

机构地区：[1]Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China [2]Hepatic Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,Hubei Province,China

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第11期587-594,共8页世界胃肠内镜杂志（英文）

摘　　要：In this editorial,we comment on the in-press article in the World Journal of Gas-trointestinal Endoscopy concerning the treatment of malignant gastric outlet obstruction(mGOO).The original theory of treatment involves bypassing the obstruction or reenabling the patency of the passage.Conventional surgical gastroenterostomy provides long-term relief of symptoms in selected patients,with substantial morbidity and a considerable rate of delayed gastric emptying.Endoscopic stenting was introduced as an alternative minimally invasive proce-dure with less procedural morbidity and rapid clinical improvement;however,it presented a high rate of long-term recurrence.Therefore,challenges remain in the treatment of mGOO patients to improve clinical outcomes.Endoscopic ultra-sound-guided gastroenterostomy has recently emerged as a promising method because of the combined effects of surgery and endoscopy,whereas stomach-partitioning gastrojejunostomy has been reported as a modified surgical proce-dure to reduce the rate of delayed gastric emptying.In decision-making regarding the treatment of choice,it should be taken into account that mGOO might be accompanied by a variety of pathological conditions,including cancer cachexia,anorexia,malabsorption,and etc.,all of which can also lead to the characteristic symptoms and poor nutritional status of mGOO.The treatment plan should consider comprehensive aspects of patients to achieve practical improve-ments in prognosis and the quality of life.

关 键 词：Malignant gastric outlet obstruction Surgical gastroenterostomy Endoscopic stenting Endoscopic ultrasound-guided gastroenterostomy Stomach-partitioning gastrojejunostomy Anorexia‒cachexia syndrome 

分 类 号：R573[医药卫生—消化系统]