Gastric outlet obstruction
ICD-10 K31.1 · ICD-11 DA40.0

Treatment of Incurable Malignant Gastric Outlet Obstruction in a Poor Surgical Candidate

When malignant gastric outlet obstruction is deemed incurable and the patient is not a suitable surgical candidate — particularly with a life expectancy of less than six months — the management approach shifts significantly. Shared decision-making is central, especially for patients who prioritise early restoration of oral intake and timely discharge.

Clinical scenario: Incurable malignant gastric outlet obstruction in a poor surgical candidate with a life expectancy of less than 6 months. Patient values — including return to oral diet and early discharge — inform the choice of intervention.
Approach
In this setting, an endoscopic approach is recommended over surgical intervention. The full protocol defines the specific procedure, anatomical targets, and the decision criteria that guide its application — see the complete regimen for details.
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References

Based on shared decision-making, in patients who are poor surgical candidates with short life expectancy (<6 months) and those who place a high value on resumption of oral diet and being discharged early, we suggest SEMS placement compared with surgical GJ.

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