Mehta 2006.

Methods	Single‐centre randomised controlled study
Participants	27 participants with malignant GOO and unresectable or advanced metastatic malignancy (or both) who were fit for intervention. Primary site of malignancy: pancreatic (56%), gastric (15%), cholangiocarcinoma (7%), gallbladder (3.5%) and metastatic disease (15%). 1 participant (3.5%) was subsequently found to have a benign gastric ulcer, as opposed to an underlying malignancy, as the cause of the GOO. Men: 13/27 (48%) Mean age: 68.9 years
Interventions	14 participants randomised to gastrojejunostomy. 13 participants underwent the procedure (1 participant died prior to the intervention). Further details: laparoscopic, antecolic gastrojejunostomy with stapled gastrojejunal anastomosis. The 2 surgeons involved in the study had undertaken laparoscopic gastrojejunostomy for 10 years and had completed over 50 cases prior to the study. 13 participants randomised to duodenal stenting. Stents were unable to be passed in 2 participants and they went on to have a gastrojejunostomy. Further details: enteral Wallstent (Boston Scientific, Natick, MA, USA) inserted either orally (8 participants) or via a percutaneous gastrostomy tract (3 participants). The radiology team had performed 21 duodenal stents prior to the study. 6 participants in the gastrojejunostomy group and 7 participants in the duodenal stenting group also underwent biliary decompression by either endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography prior to the operation.
Outcomes	Postprocedural complications Duration of hospital stay postintervention Visual analogue pain scores (preintervention versus day 1) SF‐36 scores (postintervention versus 1 month) Data analysed by intention to treat
Notes	All participants in the study presented with typical symptoms of nausea, vomiting and abdominal pain, with confirmation of diagnosis by gastroscopy, contrast swallow or computerised tomography.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Randomization was performed using a computer‐generated list concealed from the investigators at the time of enrolment."
Allocation concealment (selection bias)	Low risk	Quote: "Randomization was performed using a computer‐generated list concealed from the investigators at the time of enrolment."
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: participants consented to both treatment options prior to allocation, but would have been aware of the intervention they received.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Comment: information not available
Incomplete outcome data (attrition bias) All outcomes	High risk	Quote: "6 patients in the laparoscopic gastrojejunostomy group and 7 patients in the duodenal stenting group completed questionnaires at 1 month." Comment: therefore, 7 participants did not complete questionnaires at 1 month and the reasons were not documented.
Selective reporting (reporting bias)	Low risk	Comment: all important outcomes reported
Other bias	Low risk	Comment: no other source of bias identified. Participants were well matched for age, sex and weight. Unclear how well matched the 2 groups were for site of primary malignancy

GOO: gastric outlet obstruction; SF‐36: 36‐item Short Form Health Survey.