Introduction
Gastric outlet obstruction happens when something blocks the outlet of the stomach, preventing food and liquid from passing into the small intestine normally — causing nausea, vomiting, and an inability to eat. It can result from cancer (most commonly stomach or pancreatic cancer pressing on or growing into this area) or from non-cancer causes such as scarring from peptic ulcers, prior surgery, or pancreatitis. EUS-guided gastrojejunostomy treats this by creating a new, direct connection between the stomach and a loop of small intestine further downstream — effectively bypassing the blockage — entirely from inside the body, without surgery.
Is this procedure safe, and does it work?
Generally, yes. Across published studies, technical success — successfully creating the new connection — is achieved in roughly 9 out of 10 procedures, and most patients are able to eat again afterward, often within days. This matters enormously for a group of patients who are frequently too unwell, due to cancer or other health issues, to safely undergo the traditional surgical alternative. Complications occur in a small minority of cases, most often related to the stent not deploying exactly as planned, which can usually be managed endoscopically at the time. The section further down this page, ‘The evidence in more detail,’ has the specific study data.
What causes gastric outlet obstruction
| Cause | Type |
|---|---|
| Stomach or pancreatic cancer pressing on or growing into the outlet | Malignant (most common cause) |
| Scarring from long-standing peptic ulcers | Benign |
| Scarring from prior surgery | Benign |
| Complications of severe pancreatitis | Benign |
What to expect: before, during, and after
- Before: imaging to confirm the location and cause of the blockage
- During: performed under sedation or general anesthesia; using endoscopic ultrasound guidance, a stent is placed to create a new connection between the stomach and small intestine
- After: most patients can begin a liquid diet within a day, progressing to solid food as tolerated over the following days
- Follow-up: monitoring for symptom resolution; the stent generally remains in place long-term unless there's a specific reason to remove it
The evidence in more detail
This section is for anyone who wants the specific research behind the summary above — it's not necessary reading to understand the basics of this procedure, but it's here for transparency.
A UK multicenter study of 25 patients (88% with malignant obstruction, all considered inoperable or high surgical risk) found both technical and clinical success in 92% of patients, with a significant improvement in obstruction symptom scores and an adverse event rate of 8%, mostly related to stent positioning issues managed at the time of the procedure. A larger study of 137 patients with malignant obstruction found technical success of 92.70% and clinical success of 88.00%. For benign gastric outlet obstruction specifically, published data shows technical success ranging from 95% to 100%, with clinical success typically exceeding 80%. Stent size matters: studies comparing a wider (20mm) stent to a narrower (15mm) one found significantly better full-diet tolerance and a notably lower need for repeat procedures with the wider stent.
Gastrojejunostomy care at KAGE
EUS-guided gastrojejunostomy relieves gastric outlet obstruction without surgery, most often in advanced gastric cancer or in pancreatic conditions where a tumour blocks the stomach outlet. Performed in the Advanced Endoscopy Clinic by our gastroenterologists, it restores oral feeding in a single session and avoids a surgical bypass in patients who have little recovery time to spare. For an opinion on obstruction that is preventing eating, book a consultation.
Frequently asked questions
Patients with gastric outlet obstruction, particularly those who are too unwell for traditional surgery due to cancer or other health conditions, though it's also used for benign causes of obstruction.
Most patients can begin a liquid diet within a day, progressing to solid food over the following days as tolerated.
Coverage varies by policy; our team can help verify your specific coverage and explain costs during consultation.
Stent positioning issues, when they occur, can usually be managed endoscopically at the time of the procedure or shortly after.
Generally, yes, unless there's a specific reason to remove it — it's intended as a long-term solution to the obstruction.
Yes — benign causes such as scarring from peptic ulcers, prior surgery, or pancreatitis can also be treated this way, with strong published success rates.
A standard duodenal stent is placed directly across the blockage and can have a shorter patency time requiring repeat procedures; this technique creates an entirely new bypass route around the blockage instead.
Re-intervention rates in published studies are generally low, particularly with appropriately sized stents, though this is assessed on an individual basis.
It's uncommon in children but can be considered in specific situations, managed by KAGE's pediatric gastroenterology team.
Book a consultation at KAGE
Speak to a KAGE gastroenterologist about your symptoms, your diagnosis, or a second opinion.