Endoscopic ultrasound-guided gastrojejunostomy (eus-gj) outperforms surgical methods for malignant gastric outlet obstruction, impacting patient outcomes.

• EUS-gj shows a clinical success rate significantly higher than surgical gastrojejunostomy (rr 0.82) and enteral stents (rr 0.91).
• Surgical options are linked to longer hospital stays and increased reintervention rates compared to EUS-gj.

Consider recommending EUS-gj as the primary treatment for better patient outcomes in malignant gastric outlet obstruction.

• Enteral stents, though less expensive, carry a higher risk for reintervention (rr 7.69 vs EUS-gj).