Management of Malignant Gastric Outlet Obstruction Between Surgery and Endoscopy

Who May Qualify: - cyto-/histo-logically confirmed pancreatic cancer - a maximum of 6 months from pancreatic cancer diagnosis and candidate to active treatment - stenosis causing gastric outlet obstruction (GOO) due to neoplastic invasion/compression confirmed by radiology or endoscopy extending from the distal one third of the stomach or the duodenum - patients candidate to either ES or EUS-GE or s-GE Who Should NOT Join This Trial: - age \< 18 years - patients with benign or indeterminate gastrointestinal stenosis - patients with malignant GOO (mGOO) from neoplasia other than pancreatic cancer - candidates to upfront surgical resection or who already received curative pancreatic resection - patients who already received a treatment for mGOO - patients receiving an additional procedure for biliary drainage which might increase the risk of adverse events or hamper the assessment of quality of life; biliary drainage will be allowed if performed uneventfully (without adverse events) at least one day (endoscopic drainage) or one month (surgical hepaticojejunostomy) before mGOO treatment; - patients carrying any percutaneous drainage (such as percutaneous transhepatic biliary drainage or ascites drainage). - inability or unwillingness to sign the willing to sign a consent form form (ICF) - contraindications to any active palliation of the mGOO, or indication to palliation through venting gastrostomy or nasogastric tube placement alone Always talk to your doctor about whether this trial is right for you.