What is the benefit of endoscopic ultrasound-guided gastrojejunal anastomosis for patients with benign gastric outlet obstruction? A systematic review with meta-analysis
Bibliographic record
Abstract
<h2>Abstract</h2><h3>Background</h3> Gastric outlet obstruction for benign indications (bGOO) is an uncommon condition, typically treated with surgery when medical therapy or endoscopic treatments fail. At present, endoscopic ultrasound (EUS)-guided gastrojejunostomy (GJ) may prove to be an effective alternative. <h3>Aims</h3> We performed a systematic review with meta-analysis evaluating outcomes of EUS-GJ for bGOO. <h3>Methods</h3> A comprehensive search was conducted up to February 2025. Pooled estimates were obtained using a random-effects model. Study quality was evaluated using the Newcastle–Ottawa quality scale. Heterogeneity was evaluated with I<sup>2</sup> statistic. Technical success, clinical success, recurrence rate, and adverse events (AE) rate were the main outcomes. <h3>Results</h3> Fifteen (15) studies, including a total of 376 patients, were identified. Pooled technical success was 95.8 % (CI 95 %, 93.8 %-97.8 %, I<sup>2</sup> =0 %), while clinical success was 93.4 % (CI 95 %, 90.4 %-96.5 %, I<sup>2</sup>= 31.83 %). Pooled recurrence rate was 11.6 % (CI 95 %, 5.5 %-17.7 %, I2=32.36 %). The pooled rate of AE was 11.6 % (CI 95 %, 6.8–16.5 %, I<sup>2</sup> = 57.18 %). Subgroup analyses found differences in safety when AE classification was used (17 % use vs. 6 % no use, <i>p</i> = 0.02) and based on quality of studies (low 22 % vs. moderate 10 % vs. high 3 %, <i>p</i> = 0.04). <h3>Conclusion</h3> In conclusion, our findings show that EUS-GJ is effective and safe in those patients with bGOO in whom other endoscopic treatments fail, and surgery is not an option or could be performed as bridge-to-surgery. Our results suggest that safety is influenced by the use of AE classification and the quality of studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".