Endoscopic ultrasound-guided gastroenterostomy using a lumen apposing stent

Malignant gastric outlet obstruction (GOO) significantly impairs the quality of life of patients with advanced cancers.Historically, GOO management has relied on surgical gastrojejunostomy (GJ) and enteral stenting (ES), both of which provide durable symptomatic relief.Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is emerging as a robust alternative to surgical GJ and ES.However, it carries technical risks.We report two contrasting cases of EUS-GE following failed duodenal stenting to highlight its clinical utility and potential limitations.