ASGE guideline on the role of endoscopy in the management of benign and malignant gastroduodenal obstruction

ASGE Standards of Practice Committee; Terry L Jue; Andrew C Storm; Mariam Naveed; Douglas S Fishman; Bashar J Qumseya; Autumn J McRee; Mark J Truty; Mouen A Khashab; Deepak Agrawal; Mohammed Al-Haddad; Stuart K Amateau; James L Buxbaum; Audrey H Calderwood; John DeWitt; Christopher J DiMaio; Larissa L Fujii-Lau; Suryakanth R Gurudu; Laith H Jamil; Richard S Kwon; Joanna K Law; Jeffrey K Lee; Swati Pawa; Mandeep S Sawhney; Nirav C Thosani; Julie Yang; Sachin B Wani; (ASGE Standards of Practice Committee Chair, 2017-2020)

doi:10.1016/j.gie.2020.07.063

ASGE guideline on the role of endoscopy in the management of benign and malignant gastroduodenal obstruction

Gastrointest Endosc. 2021 Feb;93(2):309-322.e4. doi: 10.1016/j.gie.2020.07.063. Epub 2020 Nov 7.

Authors

ASGE Standards of Practice Committee; Terry L Jue¹, Andrew C Storm², Mariam Naveed³, Douglas S Fishman⁴, Bashar J Qumseya⁵, Autumn J McRee⁶, Mark J Truty⁷, Mouen A Khashab⁸, Deepak Agrawal⁹, Mohammed Al-Haddad¹⁰, Stuart K Amateau¹¹, James L Buxbaum¹², Audrey H Calderwood¹³, John DeWitt¹⁰, Christopher J DiMaio¹⁴, Larissa L Fujii-Lau¹⁵, Suryakanth R Gurudu¹⁶, Laith H Jamil¹⁷, Richard S Kwon¹⁸, Joanna K Law¹⁹, Jeffrey K Lee²⁰, Swati Pawa²¹, Mandeep S Sawhney²², Nirav C Thosani²³, Julie Yang²⁴, Sachin B Wani²⁵; (ASGE Standards of Practice Committee Chair, 2017-2020)

Affiliations

¹ Department of Gastroenterology, The Permanente Medical Group, San Francisco, California, USA.
² Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
³ Advent Health Medical Group, Gastroenterology/Hepatology, Advent Health Hospital Altamonte Springs, Altamonte Springs, Florida, USA.
⁴ Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
⁵ Department of Gastroenterology, University of Florida, Gainesville, Florida, USA.
⁶ Division of Hematology/Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
⁷ Department of Surgical Oncology, Mayo Clinic, Rochester, Minnesota, USA.
⁸ Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, USA.
⁹ Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
¹⁰ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹¹ Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
¹² Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
¹³ Department of Gastroenterology and Hepatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
¹⁴ Department of Gastroenterology, Mount Sinai, New York, New York, USA.
¹⁵ Department of Gastroenterology, The Queen's Medical Center, Honolulu, Hawaii, USA.
¹⁶ Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
¹⁷ Section of Gastroenterology and Hepatology, Beaumont Health, Royal Oak, Michigan, USA.
¹⁸ Department of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
¹⁹ Department of Gastroenterology and Hepatology, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA.
²⁰ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA.
²¹ Department of Gastroenterology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
²² Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
²³ Division of Gastroenterology, Hepatology and Nutrition, McGovern Medical School, UTHealth, Houston, Texas, USA.
²⁴ Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
²⁵ Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

PMID: 33168194
DOI: 10.1016/j.gie.2020.07.063

Abstract

This American Society for Gastrointestinal Endoscopy guideline provides evidence-based recommendations for the endoscopic management of gastric outlet obstruction (GOO). We applied the Grading of Recommendations, Assessment, Development and Evaluation methodology to address key clinical questions. These include the comparison of (1) surgical gastrojejunostomy to the placement of self-expandable metallic stents (SEMS) for malignant GOO, (2) covered versus uncovered SEMS for malignant GOO, and (3) endoscopic and surgical interventions for the management of benign GOO. Recommendations provided in this document were founded on the certainty of the evidence, balance of benefits and harms, considerations of patient and caregiver preferences, resource utilization, and cost-effectiveness.

Publication types

Practice Guideline

MeSH terms

Gastric Outlet Obstruction* / etiology
Gastric Outlet Obstruction* / surgery
Humans
Palliative Care
Retrospective Studies
Self Expandable Metallic Stents*
Stents
Stomach Neoplasms* / complications
Treatment Outcome