Role of Endoscopy in the Management of Benign and Malignant Gastroduodenal Obstruction
Patient Guideline Summary
Publication Date: January 31, 2021
Last Updated: March 3, 2023
Objective
Objective
This patient summary means to discuss key recommendations from the American Society for Gastrointestinal Endoscopy (ASGE) for the role of endoscopy in the management of benign and malignant gastroduodenal obstruction. It is limited to adults 18 years of age and older and should not be used as a reference for children.
Overview
Overview
- Gastroduodenal Obstruction is a blockage of the outlet of the stomach.
- We will use the abbreviation GOO throughout this summary to refer to gastric outlet obstruction.
- Some of the most common causes of GOO are stomach ulcers and cancer.
- Symptoms include early satiety (feeling that the stomach is full), weight loss, nausea, vomiting, and abdominal pain.
- This patient summary focuses on the endoscopic management of GOO.
Treatment
Treatment
- Factors that should be considered in determining appropriate management of GOO include the cause of GOO and the length of the narrow segment.
- For benign causes, initial endoscopic balloon dilation (EBD) is the treatment of choice.
- For incurable cancer, ASGE recommends either a self-expandable metallic stent (SEMS) placed through an endoscope or open surgical removal of the obstruction.
- Evidence is insufficient to recommend treatments for other varieties of obstruction.
Abbreviations
- ASGE: American Society For Gastrointestinal Endoscopy
- EBD: Endoscopic Balloon Dilation
- GOO: Gastroduodenal Obstruction
- SEMS: Self-expandable Metallic Stent
Source Citation
ASGE Standards of Practice Committee; Jue TL, Storm AC, Naveed M, Fishman DS, Qumseya BJ, McRee AJ, Truty MJ, Khashab MA, Agrawal D, Al-Haddad M, Amateau SK, Buxbaum JL, Calderwood AH, DeWitt J, DiMaio CJ, Fujii-Lau LL, Gurudu SR, Jamil LH, Kwon RS, Law JK, Lee JK, Pawa S, Sawhney MS, Thosani NC, Yang J, Wani SB; (ASGE Standards of Practice Committee Chair, 2017-2020). 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. PMID: 33168194.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.