Korean J Gastroenterol.  2024 Jul;84(1):3-8. 10.4166/kjg.2024.054.

Treatment Strategies for Gastric Cancer Patients with Gastric Outlet Obstruction

• Lim H

• KMID: 2558283
• DOI: http://doi.org/10.4166/kjg.2024.054

Abstract

Gastric cancer frequently leads to gastric outlet obstruction (GOO), causing significant symptoms and complications. Surgical bypass and stenting are two representative palliative treatments for GOO by gastric cancer. This study reviews clinical guidelines for malignant GOO treatment, highlighting differences in recommendations based on patient survival expectations and systemic health. A meta-analysis of surgical bypass and stenting in gastric cancer patients revealed no significant difference in technical and clinical success rates between the two treatments. However, stenting allowed faster resumption of oral intake and shorter hospital stays but had higher rates of major complications and reobstruction. Despite these differences, overall survival did not significantly differ between the two groups. Emerging techniques like EUS-guided gastrojejunostomy show promise but require further research and experienced practitioners. Ultimately, treatment should be tailored to patient preferences and the specific benefits and drawbacks of each method to improve quality of life and outcomes.

Keyword

Gastric cancer; Gastric outlet obstruction; Stents; Surgical bypass; Treatment outcome

Figure

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  Fig. 1 Forest plot results of meta-analysis of procedure outcomes. (A) Technical success. (B) Clinical success. (C) Overall survival (from Kim et al.2).

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