{"entity":{"id":"duodenal-stenting-gastric-outlet","kind":"term","name":"Duodenal stenting and gastrojejunostomy for malignant gastric outlet obstruction","aka":["Duodenal stent","Enteral stent","Gastrojejunostomy","EUS-guided gastroenterostomy","Gastric outlet obstruction"],"tldr":"A gallbladder tumour can press on the duodenum so food cannot leave the stomach. A metal stent placed by endoscope relieves this within days; a surgical bypass (gastrojejunostomy) takes longer to work but lasts longer, so the choice depends on how long the person is expected to live.","summary":"Gallbladder cancer invades the duodenum by direct extension or hilar nodes. The Dutch SUSTENT randomised trial (39 patients) found that food intake improved faster after stent placement than after gastrojejunostomy (median 5 versus 8 days) but that long-term relief was better after surgery (72 versus 50 days with adequate intake), with more major complications, recurrent obstruction and reinterventions after stenting and no difference in survival (56 versus 78 days) or quality of life; the authors proposed stents for those expected to live under two months and bypass for the rest. Endoscopic ultrasound-guided gastroenterostomy with a lumen-apposing metal stent is the newer middle path: in a 93-patient international comparison it matched surgical bypass for clinical success (87 versus 90 percent) with a trend to fewer adverse events (16 versus 25 percent) and recurrences (3 versus 14 percent). Duodenal obstruction often coexists with biliary obstruction, and the biliary stent should be placed first or through the enteral stent.","asOf":"2026-09-24","links":[{"label":"SUSTENT: surgical gastrojejunostomy or endoscopic stent placement for malignant gastric outlet obstruction, multicentre randomised trial (GIE 2010)","url":"https://doi.org/10.1016/j.gie.2009.09.042"},{"label":"EUS-guided gastroenterostomy versus surgical gastrojejunostomy: international multicentre comparison (Endoscopy 2017)","url":"https://doi.org/10.1055/s-0043-101695"},{"label":"Pancreatic Cancer UK: stents for a blocked duodenum","url":"https://www.pancreaticcancer.org.uk/information-and-support/treatments-for-pancreatic-cancer/stents-for-a-blocked-duodenum/"},{"label":"Pancreatic Cancer UK: bypass surgery if you have pancreatic cancer","url":"https://www.pancreaticcancer.org.uk/information-and-support/treatments-for-pancreatic-cancer/bypass-surgery-if-you-have-pancreatic-cancer/"},{"label":"Pancreatic Cancer UK: feeling sick and being sick","url":"https://www.pancreaticcancer.org.uk/information-and-support/managing-symptoms-and-side-effects/feeling-and-being-sick/"},{"label":"Cancer Research UK: your diet and pancreatic cancer","url":"https://www.cancerresearchuk.org/about-cancer/pancreatic-cancer/living-with/diet"},{"label":"NICE NG85: pancreatic cancer in adults, diagnosis and management, recommendations","url":"https://www.nice.org.uk/guidance/ng85/chapter/Recommendations"}],"tags":[],"related":[],"cancers":["gallbladder","pancreatic","gastric"],"sections":[],"technologies":["palliative-care"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["biliary-stent","endoscopy","palliative-care"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Pancreatic cancer: vomiting large amounts, especially after food, and feeling full can mean the cancer is blocking the duodenum. Pancreatic Cancer UK says a duodenal stent takes 30 to 40 minutes under sedation and you should feel better within a couple of days; NICE NG85 says consider a gastrojejunostomy rather than a stent for people with a more favourable prognosis. Cancer Research UK's diet after a stent: soft, moist, lower-fibre food, little and often, chew well and stay upright."],"category":"Procedures"},"route":"/terms/duodenal-stenting-gastric-outlet/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"palliative-care","kind":"technology","name":"Early integrated palliative care","route":"/technologies/palliative-care/"}],"term":[{"id":"endoscopy","kind":"term","name":"Endoscopy (EGD, EUS, ERCP)","route":"/terms/endoscopy/"},{"id":"biliary-stent","kind":"term","name":"Stenting (biliary, oesophageal, airway)","route":"/terms/biliary-stent/"},{"id":"gallbladder-cancer-symptom-control","kind":"term","name":"Symptom control in advanced gallbladder cancer: pain, ascites and nutrition","route":"/terms/gallbladder-cancer-symptom-control/"},{"id":"urgent-help-pancreatic-cancer","kind":"term","name":"When to seek urgent help with pancreatic cancer (NHS 111 and 999)","route":"/terms/urgent-help-pancreatic-cancer/"}]}}