A 2026 research study of 139 patients found that both duodenal and jejunal placement of endoscopic ultrasound-guided gastroenterostomy work equally well for treating blocked stomachs. According to Gram Research analysis, 98% of patients with jejunal placement and 94% with duodenal placement could eat soft foods within a week, with no statistically significant difference in complication rates between the two approaches. This gives doctors flexibility in choosing the best placement location for each patient’s unique situation.
Doctors have a new way to help patients whose stomachs aren’t emptying properly. Using a special camera and ultrasound, they can create a small opening between the stomach and intestines to bypass the blockage. According to Gram Research analysis, this study compared two different placement locations for this opening and found both work equally well. Researchers looked at 139 patients and found that about 95% could eat soft foods within a week after the procedure, with few serious complications. This gives doctors more flexibility in choosing the best approach for each patient.
Key Statistics
A 2026 research study of 139 patients found that 98% of those receiving jejunal placement and 94% receiving duodenal placement for endoscopic ultrasound-guided gastroenterostomy could eat soft foods within 7 days, with no significant difference between the two approaches.
In a 2026 analysis of 139 patients undergoing endoscopic ultrasound-guided gastroenterostomy, the adverse event rate was 22% for jejunal placement versus 12% for duodenal placement, a difference that was not statistically significant.
A 2026 study of 139 patients found that stent misdeployment occurred in 7% of jejunal placements compared to 0% of duodenal placements for endoscopic ultrasound-guided gastroenterostomy, though this difference was not statistically significant.
The Quick Take
- What they studied: Whether creating a bypass opening in two different locations (the duodenum versus the jejunum, both parts of the small intestine) works equally well for patients whose stomachs can’t empty food properly.
- Who participated: 139 adult patients with an average age of 67 years (ranging from 61 to 74), about 41% women, who had this procedure between 2020 and 2024. Most had cancer or other conditions blocking their stomach outlet.
- Key finding: Both placement locations worked well: 98% of patients with the jejunal placement and 94% with the duodenal placement could eat soft foods within a week. The difference wasn’t statistically significant, meaning both are equally effective.
- What it means for you: If you or a loved one needs this procedure, doctors now have evidence that both placement options are safe and effective. Your doctor can choose based on what’s best for your specific situation. However, this is a specialized procedure only available at certain medical centers.
The Research Details
Researchers reviewed records of 139 patients who had a procedure called endoscopic ultrasound-guided gastroenterostomy (EUS-GE) between 2020 and 2024. This procedure uses a special camera with ultrasound technology to create a small opening between the stomach and intestines, bypassing a blockage. Patients were divided into two groups based on where the opening was placed: 105 patients had it placed in the jejunum (further down the intestines) and 34 had it placed in the duodenum (closer to the stomach). The doctors then compared how well each group did after the procedure.
The main thing they measured was whether patients could eat soft foods within 7 days after surgery. They also tracked any problems that happened, including whether the stent (the tube keeping the opening open) moved, got blocked, or caused bleeding or infection. They used standard statistical methods to determine if the differences between groups were meaningful or just due to chance.
This research matters because it helps doctors make better decisions during surgery. Previously, doctors typically placed the opening in the jejunum because that’s what they learned to do. But if the duodenum works just as well, it might be easier or safer in some cases. Understanding that both options are effective gives doctors more tools to customize treatment for each patient’s unique situation.
This study has several strengths: it included a reasonable number of patients (139), used clear definitions for success, and tracked multiple types of complications. However, it’s a retrospective study, meaning researchers looked back at medical records rather than randomly assigning patients to treatment groups. This means some differences between groups could be due to factors other than the procedure itself. The study was also conducted at a single center, so results might not apply everywhere. Additionally, the groups were unequal in size (105 versus 34 patients), which can affect statistical comparisons.
What the Results Show
The main finding was that both surgical approaches worked very well. In the jejunal placement group, 98% of patients (103 out of 105) could eat soft foods by day 7. In the duodenal placement group, 94% of patients (32 out of 34) achieved this goal. The difference between 98% and 94% was not statistically significant, meaning it could easily be due to chance rather than a real difference between the two methods.
Complication rates were low in both groups and very similar. The jejunal group had a 22% rate of any adverse event (complications), while the duodenal group had a 12% rate. This difference also wasn’t statistically significant. Specific complications were rare in both groups: stent blockage occurred in 12% of jejunal cases versus 6% of duodenal cases, bleeding happened in 2% versus 6%, and perforation (a hole in the intestine) occurred in 4% of jejunal cases with none in the duodenal group.
The stent misdeployment rate (when the tube doesn’t open properly) was 7% in the jejunal group and 0% in the duodenal group, though this difference wasn’t statistically significant due to the small number of events. Unplanned procedures to fix problems were needed in 14% of jejunal cases and 9% of duodenal cases.
Several other outcomes showed no significant differences between groups. Stent migration (the tube moving out of place) occurred in only 1% of jejunal cases and 0% of duodenal cases. Infection was rare, happening in 3% of jejunal cases and 0% of duodenal cases. These low rates suggest both procedures are generally safe. The fact that the duodenal approach had slightly lower complication rates in several categories is interesting but not statistically proven, meaning we can’t be certain these differences are real.
This study adds important new information to a growing body of research on endoscopic approaches to gastric outlet obstruction. Previously, most doctors used the jejunal approach because it was the established standard. This research suggests that the duodenal approach, which might be technically easier in some cases, is equally effective. The high success rates (94-98%) are consistent with other recent studies of this procedure, confirming that endoscopic approaches are a good alternative to traditional surgery for appropriate patients.
Several limitations should be considered. First, this was a retrospective study, meaning researchers looked back at existing medical records rather than randomly assigning patients to treatment groups. This can introduce bias because the two groups might have been different in ways that affected outcomes. Second, the groups were unequal in size (105 versus 34), which can make statistical comparisons less reliable. Third, the study was conducted at a single medical center, so results might not apply to other hospitals or different patient populations. Fourth, the study didn’t report how long patients were followed after the procedure, so we don’t know about long-term outcomes. Finally, the reasons why doctors chose one placement over another weren’t clearly explained, which could affect the comparison.
The Bottom Line
Based on this research, both duodenal and jejunal placement are reasonable options for patients needing this procedure. Doctors can choose based on what’s technically easiest during the procedure and what’s best for each patient’s anatomy. The high success rate (94-98%) and low complication rate (12-22%) suggest this is a good option for patients who can’t have traditional surgery or who want to avoid it. However, this procedure should only be done by experienced endoscopists at specialized medical centers.
This research is most relevant for patients with gastric outlet obstruction (blocked stomach) who aren’t candidates for traditional surgery or prefer a less invasive approach. It’s also important for gastroenterologists (digestive system doctors) and interventional endoscopists who perform these procedures. Patients with cancer, ulcers, or other conditions causing stomach blockage should discuss this option with their doctors. This procedure is not appropriate for patients who can have traditional surgery or whose blockage can be treated with less invasive methods.
Most patients in this study could eat soft foods within 7 days after the procedure. However, full recovery and return to normal diet may take several weeks. Some patients may need additional procedures if the stent becomes blocked or moves. Long-term outcomes beyond the initial recovery period weren’t reported in this study, so ask your doctor about expected timeline for your specific situation.
Frequently Asked Questions
What is endoscopic ultrasound-guided gastroenterostomy and how does it work?
It’s a minimally invasive procedure where doctors use a special camera with ultrasound to create a small opening between the stomach and intestines, bypassing a blockage. A stent (small tube) keeps the opening open, allowing food to pass through. It’s done without major surgery.
Is duodenal or jejunal placement better for this procedure?
A 2026 study of 139 patients found both placements equally effective, with 98% and 94% success rates respectively. Doctors can choose based on what’s technically best for each patient’s anatomy. Neither approach is clearly superior.
What are the risks and complications of this procedure?
Complications are generally rare. In a 2026 study, adverse events occurred in 12-22% of cases, including stent blockage (6-12%), bleeding (2-6%), and perforation (0-4%). Most patients tolerate the procedure well with minimal problems.
How long does it take to eat normally after this procedure?
Most patients can eat soft foods within 7 days after the procedure. Full recovery and return to a normal diet typically takes several weeks. Your doctor will give you specific dietary guidelines based on your individual situation.
Who is a good candidate for this procedure instead of traditional surgery?
Patients with gastric outlet obstruction who can’t have traditional surgery or prefer a less invasive approach are good candidates. This includes many patients with cancer or severe ulcers. Your doctor will determine if you’re appropriate based on your specific condition.
Want to Apply This Research?
- Track daily diet progression after the procedure: record what foods you can tolerate (liquids only, soft foods, regular diet) and any symptoms like nausea, vomiting, or abdominal pain. Use a simple 1-10 scale to rate how well you’re tolerating food each day.
- If you’re scheduled for this procedure, use the app to set reminders for post-procedure dietary guidelines and to log any complications or concerns. Create a symptom diary to share with your doctor at follow-up appointments, noting when you can advance to new food types.
- Set up weekly check-ins for the first month to track stent function and diet tolerance. Create alerts for warning signs like severe vomiting, inability to eat, or abdominal pain that would require contacting your doctor. After the first month, switch to monthly monitoring to track long-term stent function and diet quality.
This article summarizes research about a specialized medical procedure. It is not medical advice. Endoscopic ultrasound-guided gastroenterostomy is a complex procedure that should only be performed by experienced specialists at qualified medical centers. If you have gastric outlet obstruction or symptoms of stomach blockage, consult with a gastroenterologist or surgeon to discuss whether this procedure is appropriate for your specific condition. Individual results vary, and your doctor should discuss both benefits and risks based on your medical history and current health status.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.