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Related Experiment Video

Updated: May 21, 2025

Vessel-sparing Excision and Primary Anastomosis
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Endoscopic approaches to small bowel strictures.

Katelin Durham1, Rami El Abiad2, Mouen Khashab3

  • 1Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA - katelin-durham@uiowa.edu.

Minerva Gastroenterology
|March 21, 2025
PubMed
Summary
This summary is machine-generated.

Small bowel strictures cause significant morbidity. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using advanced stents offers a streamlined approach for malignant gastric outlet obstruction (GOO), improving patient outcomes.

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Surgical Oncology

Background:

  • Small bowel strictures, benign or malignant, lead to considerable morbidity and reduced quality of life.
  • Treatment strategies for small bowel strictures depend on stricture location, degree of stenosis, and etiology.

Purpose of the Study:

  • To review endoscopic management options for small bowel strictures.
  • To focus on endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for malignant gastric outlet obstruction (GOO).
  • To compare EUS-GE with enteral stenting and surgical gastrojejunostomy for malignant GOO.

Main Methods:

  • Literature review of endoscopic interventions for small bowel strictures.
  • Emphasis on endoscopic balloon dilation, enteral stenting, EUS-GE, and stricturotomy.
  • Evaluation of cautery-enhanced lumen-apposing metal stents in EUS-GE.

Main Results:

  • Cautery-enhanced lumen-apposing metal stents have improved the efficacy and application of EUS-GE.
  • EUS-GE is a viable option for select patients with malignant GOO, offering acceptable survival.
  • Comparative data on EUS-GE versus traditional enteral stents and surgical gastrojejunostomy are discussed.

Conclusions:

  • Endoscopic interventions provide crucial management options for small bowel strictures.
  • EUS-GE, particularly with advanced stenting technology, is a leading approach for malignant GOO.
  • Further comparative studies are needed to fully elucidate the optimal treatment pathway.