Endoscopic ultrasound guided-gastroenterostomy is the best choice in the treatment of gastric outlet obstruction.

Abstract

First of all, I would like to congratulate Vilas-Boas et al on an interesting publication. In this letter the authors write about very interesting topics in the management of patients with malignant gastric outlet obstruction (GOO). GOO developed in up to 20% of patients with advanced hepatopancreatobiliary disease both in benign and malignant form. For this reason, the issue is very current. I fully agree with Vilas-Boas et al that technical aspect of the procedures (surgeon's view) often differs from the patient's view (regarding such factors as cancer-related survival, overall survival, body mass composition, nutritional biomarkers, chemotherapy tolerance and patient-reported quality of life). The mentioned factors should be taken into account when interpreting the effectiveness of treatment modalities for malignant GOO (mGOO), which should be also considered in the future studies in this subject. In my opinion, all above mentioned factors could be summarized in one term: "Improving quality of life of patients with mGOO".