Role of Endoscopy in the Management of Benign and Malignant Gastroduodenal Obstruction

Publication Date: February 1, 2021
Last Updated: March 14, 2022


In patients with incurable malignant gastric outlet obstruction (GOO) undergoing palliative intervention, we suggest either self-expandable metallic stents (SEMS) placement or surgical GJ. The selected approach should be based on patient characteristics and preferences, multidisciplinary input, and local expertise. (CL)

In patients with incurable malignant GOO undergoing palliative endoscopic stent placement there is insufficient evidence to preferentially recommend either covered or uncovered SEMS. The final decision should be based on regional stent availability, patient characteristics, and patient preference. (CM)

There is insufficient evidence to uniformly support either endoscopic or surgical management for mixed varieties of benign GOO. (CL)

Comment: Factors that should be considered in determining appropriate management include etiology of benign GOO, length of stricture, and response to initial endoscopic balloon dilation (EBD).

Recommendation Grading




Role of Endoscopy in the Management of Benign and Malignant Gastroduodenal Obstruction

Authoring Organization

Publication Month/Year

February 1, 2021

Last Updated Month/Year

August 15, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Hospital

Intended Users

Physician, nurse, medical techologist technician, nurse practitioner, physician assistant



Diseases/Conditions (MeSH)

D004380 - Duodenal Obstruction


endoscopy, Guidelines, gastroduodenal obstruction, benign and malignant, edoscopic management

Source Citation

ASGE Standards of Practice Committee; Jue TL, Storm AC, Naveed M, Fishman DS, Qumseya BJ, McRee AJ, Truty MJ, Khashab MA, Agrawal D, Al-Haddad M, Amateau SK, Buxbaum JL, Calderwood AH, DeWitt J, DiMaio CJ, Fujii-Lau LL, Gurudu SR, Jamil LH, Kwon RS, Law JK, Lee JK, Pawa S, Sawhney MS, Thosani NC, Yang J, Wani SB; (ASGE Standards of Practice Committee Chair, 2017-2020). ASGE guideline on the role of endoscopy in the management of benign and malignant gastroduodenal obstruction. Gastrointest Endosc. 2021 Feb;93(2):309-322.e4. doi: 10.1016/j.gie.2020.07.063. Epub 2020 Nov 7. PMID: 33168194.