CLINICAL REVIEWSClinical Review of EUS-guided Gastroenterostomy (EUS-GE)Carbajo, Ana Y. MD*; Kahaleh, Michel MD†; Tyberg, Amy MD†Author Information *University Hospital Rio Hortega, Valladolid, Spain †Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ A.T. has done consulting work for EndoGastric Solutions, NinePoint Medical, and Obalon Therapeutics. M.K. has Grant support from Boston Scientific, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, NinePoint Medical, Merit Medical, Olympus, and Interscope Med. Consultant for Boston Scientific, Concordia Laboratories Inc., Interscope Med. and ABBvie. A.Y.C. declares that there is nothing to disclose. Address correspondence to: Michel Kahaleh, MD, Rutgers, The State University of New Jersey, Robert Wood Johnson University Hospital, 1 RWJ Place, MEB 491B, New Brunswick, NJ 08901 (e-mail: firstname.lastname@example.org). Online date: September 18, 2019 Journal of Clinical Gastroenterology: January 2020 - Volume 54 - Issue 1 - p 1–7 doi: 10.1097/MCG.0000000000001262 Buy Metrics Abstract Gastric outlet obstruction (GOO) refers to mechanical obstruction of the distal stomach or proximal duodenum and it is associated with a significant decrease in quality of life. Surgical gastrojejunostomy and self-expandable metal stents were the traditional treatment for GOO. Recently, endoscopic ultrasound guided gastroenterostomy (EUS-GE) has emerged as a third therapeutic option for patients with GOO. Most EUS-GE techniques utilize the placement of a lumen-apposing metal stent under echoendoscopy but differ in the method of localizing the jejunal loop prior to EUS puncture. Data supporting EUS-GE have been promising. Case series including 10 or more cases showed the technical success rate to be approximately 90%. Clinical success is achieved in approximately 85–90% and a less than 18% risk of adverse events is reported. EUS-GE was associated with a lower recurrence of GOO and need for re-intervention when compared to enteral stenting. In addition, EUS-GE shows significantly fewer adverse events compared with surgical gastrojejunostomy. In conclusion, EUS-GE provides symptom relief without the risks of surgical intervention and the limited patency of enteral SEMS placement. EUS-GE is an exciting new option in the management of GOO. Despite the excellent results, randomized studies comparing these different modalities of treatment for GOO are needed before EUS-GE can be accepted as standard of care. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.