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. 2022 Jun 10;10(6):E874–E897. doi: 10.1055/a-1794-0635

Table 2. Summary of efficacy and safety meta-analytic outcomes for three treatments for malignant gastric outlet obstruction.

Duodenal SEMS EUS-GJ Surgical GJ P value 1
N studies N patients % (95 % CI) N studies N patients % (95 % CI) N studies N patients % (95 % CI)
Efficacy outcomes

  • Technical success

 45 4413 99.4 % (98.9 % to 99.8 %) 8 245 95.3 % (89.3 % to 98.9 %) 13 564 99.9 % (99.5 % to 100.0 %) 0.0048

  • Clinical success

 45 4590 88.9 % (86.7 % to 90.9 %) 8 245 89.0 % (82.3 % to 94.3 %) 13 588 92.3 % (86.9 % to 96.3 %) 0.49

  • Preprocedural GOOSS score

 27 2655 0.62 (0.50 to 0.73) 2 65 0.60 (0.44 to 0.76) 6 215 0.68 (0.52 to 0.83) 0.78

  • Postprocedural GOOSS score

 19 2184 2.27 (2.12 to 2.41) 2 59 2.57 (1.83 to 3.32) 5 180 2.20 (1.48 to 2.92) 0.71

  • Recurrence of GOO

 11 573 28.7 % (19.7 % to 38.6 %) 1 25 4.0 % (0.0 % to 15.0 %) 8 342 16.9 % (11.6 % to 23.0 %) 0.0036

  • Reintervention

 33 2963 20.3 % (16.9 % to 23.9 %) 4 129 11.2 % (4.9 % to 19.6 %) 9 418 12.6 % (6.6 % to 20.1 %) 0.041
Safety outcomes

  • Any procedure-related adverse event

 43 4285 18.7 % (14.7 % to 23.1 %) 6 189 21.9 % (16.3 % to 28.1 %) 16 746 23.8 % (18.6 % to 29.5 %) 0.32

  • Bleeding

 25 2854 1.7 % (0.9 % to 2.7 %) 4 141 2.9 % (0.2 % to 8.6 %) 9 412 5.2 % (3.2 % to 7.5 %) 0.0048

  • Perforation

 24 2823 1.6 % (1.1 % to 2.3 %) 3 105 2.8 % (0.0 % to 10.7 %) 3 170 2.0 % (0.0 % to 7.3 %) 0.88

  • Stent migration

 33 3451 4.8 % (3.6 % to 6.1 %) 4 116 2.4 % (0.0 % to 10.1 %) 0 --- --- 0.45

  • Stent occlusion

 22 1993 12.9 % (7.9 % to 18.8 %) 3 69 0.5 % (0.0 % to 4.2 %) 0 --- --- 0.0002

  • Tissue ingrowth

 22 2172 10.9 % (7.5 % to 14.8 %) 1 24 4.2 % (0.0 % to 15.6 %) 0 --- --- 0.22

  • Stent patency

 3 140 85.9 % (79.7 % to 91.2 %) 0 --- --- 0 --- --- ---

  • Tissue overgrowth

 20 1962 5.5 % (4.1 % to 7.1 %) 0 --- --- 0 --- --- ---

  • Laparoscopic complication

 0 --- --- 0 --- --- 5 196 16.1 % (6.8 % to 28.2 %) ---

  • Deaths reported in AE section

 26 2151 0.8 % (0.2 % to 1.7 %) 4 151 1.7 % (0.0 % to 8.7 %) 8 421 0.9 % (0.1 % to 2.9 %) 0.89

  • Total unique studies or patients

 47 4711 --- 8 243 --- 18 818 ---

SEMS, self-expanding metal stent; EUS-GJ, endoscopic ultrasound-guided gastrojejunostomy; GOO, gastric outlet obstruction; GOOSS, Gastric Outlet Obstruction Scoring System; AE, adverse event.

1

P value for comparison of duodenal SEMS vs. EUS-GJ vs. surgical GJ.