EUS-guided gastroenterostomy (EUS-GE) shows superior outcomes for malignant gastric outlet obstruction (MGO) compared to traditional surgical approaches.

• EUS-GE has a re-intervention rate of just 17% compared to 30% for surgical gastrojejunostomy (SGJ) and significantly lower than enteral stenting.
• Clinical success rates are higher with EUS-GE (20% more successful than enteral stenting).
• EUS-GE shortens hospital stay by an average of 6 days and time to oral intake by 2 days compared to SGJ.

Surgeons should consider EUS-GE as the preferred option for MGO to improve patient outcomes and reduce recovery times.

• Technical success rates were similar across all methods, with minor inconsistencies noted.