Endoscopic ultrasound-guided gastroenterostomy: The new standard treatment of gastric outlet obstruction

Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as an effective and minimally invasive alternative for treating gastric outlet obstruction. Compared to traditional options, including duodenal stenting and surgical gastrojejunostomy, EUS-GE offers comparable technical and clinical success while providing longer-lasting patency, fewer adverse events, and lower reintervention rates. The technique has expanded beyond malignant obstruction to include benign etiologies and complex conditions such as afferent loop syndrome. EUS-GE enables rapid recovery and early resumption of oral intake, which is crucial for oncologic patients. However, the procedure remains technically demanding, and optimal techniques, device selection, and management of complications are still under investigation. This mini-review summarizes current evidence, compares EUS-GE with alternative therapies, discusses patient selection and procedural aspects, and outlines key areas for future research.