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World J Gastrointest Endosc. Aug 16, 2024; 16(8): 451-461
Published online Aug 16, 2024. doi: 10.4253/wjge.v16.i8.451
Unveiling hidden outcomes in malignant gastric outlet obstruction research – insights from a "Pancreas 2000" review
Bahadır Bozkırlı, Giuseppe Vanella, Gabriele Capurso, Sebastien Gaujoux, Stuart Robinson, Charles De Ponthaud, Giacomo Emanuele Maria Rizzo, Filipe Vilas-Boas
Filipe Vilas-Boas, Department of Gastroenterology, São João University Hospital, Porto 4200, Portugal
Giacomo Emanuele Maria Rizzo, Endoscopy Service, Department of Diagnostic and Therapeutic Services, Scientific Institute for Research, Hospitalization and Healthcare - The Mediterranean Institute for Transplantation and Highly Specialized Therapies, Palermo 90127, Sicilia, Italy
Charles De Ponthaud, Sebastien Gaujoux, Department of Digestive, Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtriere, Sorbonne Université, Paris 75013, Île-de-France, France
Stuart Robinson, Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Newcastle NE7 7DN, Newcastle upon Tyne, United Kingdom
Gabriele Capurso, Giuseppe Vanella, Division of Pancreato-Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano 20132, Italy
Bahadır Bozkırlı, Department of General Surgery, HPB-Unit, Acıbadem Maslak Hospital, Istanbul 34398, Türkiye
Author contributions: Vilas-Boas F and Bozkirli B contributed to literature search, compilation of relevant literature and drafting of the manuscript; Capurso G, Robinson S, and Gaujoux S contributed to article conception and critical revision of the manuscript; Vanella G, De Ponthaud C and Rizzo G contributed to compilation of relevant literature, critical review and revision of the manuscript; All the authors approved the final version of the article to be published.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Vanella, MD, PhD, Adjunct Professor, Doctor, Division of Pancreato-Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, Milan 20132, Italy. vanella.giuseppe@hsr.it
Received: June 15, 2024
Revised: July 6, 2024
Accepted: July 16, 2024
Published online: August 16, 2024
Processing time: 47 Days and 9.6 Hours
Abstract

Malignant gastric outlet obstruction (mGOO) is a major condition affecting patients with periampullary tumors, including pancreatic cancer. The current treatment options include surgical gastroenterostomy, endoscopic stenting and more recently EUS-guided gastroenterostomy. Most studies comparing the outcomes of the three procedures focus on technical success, clinical success and safety. Several “occult” outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival, such as body mass composition, nutritional biomarkers, chemotherapy tolerance and patient-reported quality of life. The aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

Keywords: Malignant gastric outlet obstruction; Endoscopic ultrasound-guided gastroenterostomy; Patient-reported outcomes; Body composition; Nutrition; Quality of life

Core Tip: Gastric outlet obstruction (GOO) is a common complication in pancreatobiliary malignancies, with growing research on its surgical and endoscopic management. However, current studies often overlook the patient's perspective and important clinical outcomes. This publication discusses the need to incorporate body mass composition, nutritional status, chemotherapy tolerance, and quality of life into future GOO research to provide a more comprehensive understanding of patient well-being and treatment effectiveness.