Benign gastric outlet obstruction (GOO) presents a distinct clinical challenge requiring a considered, structured management strategy. The non-malignant aetiology shapes both the choice of intervention and the realistic goals of treatment.
This protocol addresses patients with confirmed benign gastric outlet obstruction. Evidence is insufficient to uniformly favour one management approach over another across mixed varieties of benign GOO, making a protocol-driven framework particularly important.
An endoscopic-first strategy is the typical starting point in this setting. The full protocol specifies which endoscopic interventions are applied, what modifiable contributing factors must be addressed alongside the primary intervention, and under what circumstances alternative endoscopic options or further escalation become appropriate.
Successful resolution of benign gastric outlet obstruction. Surgical intervention is reserved as a salvage option when endoscopic approaches are insufficient or when a serious complication of endoscopic therapy requires operative management.
There is insufficient evidence to uniformly support either endoscopic or surgical management for mixed varieties of benign GOO.
Rather, endoscopic management is typically attempted first, with the goal of successfully resolving benign GOO, whereas surgery is reserved for “salvage” therapy if endoscopic interventions prove insufficient or if a severe adverse event after endoscopic therapy occurs that requires surgical intervention (ie, perforation).
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