Management of Malignant Gastric Outlet Obstruction in Pancreatic Cancer Comparing Surgery and Endoscopy

What this Trial Is About

This research aims to compare the outcomes of three different procedures used to manage malignant Gastric Outlet Obstruction (GOO) caused by pancreatic cancer. GOO is a common complication in patients with biliopancreatic and gastroduodenal tumors, causing symptoms like vomiting, dehydration, and malnutrition, which can affect quality of life and chemotherapy tolerance. The study is observational, prospective, multicenter, and compares surgical gastroenterostomy, endoscopic stent placement, and EUS-guided gastroenterostomy in a uniform group of patients with recently diagnosed pancreatic adenocarcinoma. The procedures being evaluated include surgical gastrojejunostomy, which creates a surgical connection between the stomach and jejunum; endoscopic placement of self-expandable metal stents that open the obstructed area; and EUS-guided gastrojejunostomy, which uses endoscopic ultrasound to place a metal stent creating a bypass between the stomach and a jejunal loop. Each participating center will perform the procedure that is standard in their practice without additional interventions beyond the study’s assessments. Participants will complete quality of life questionnaires at the start and during follow-up visits, but no extra procedures are required due to study participation. Researchers will monitor clinical success within 30 days, eating experience over 3 months, chemotherapy tolerance over 24 months, and nutritional status including body mass index and body composition over 6 months. Data collected during routine cancer care will be shared to evaluate the clinical impact, safety, and patient experience of each treatment method.

Management of Malignant Gastric Outlet Obstruction Between Surgery and Endoscopy