Suspected GOO
Non-bilious vomiting, early satiety, distension
All Pathways
Upper GI SurgeryManagement
Gastric Outlet Obstruction Management
Gastric Outlet Obstruction Management: Suspected GOO → Initial Management → Diagnostic Workup → Etiology → Benign Causes.
Pathway Overview
11 steps
Algorithm Steps
11 total
01Start 02Action Initial Management
NPO, NG decompression, IV fluids
- Correct metabolic alkalosis
- PPI therapy
- Nutrition assessment
03Action Diagnostic Workup
CT, EGD with biopsies
- CT abdomen with contrast
- EGD with multiple biopsies
- UGI series if needed
04Decision Etiology
- Benign (PUD, caustic, Crohn's)
- Malignant (gastric, pancreatic)
05Action Benign Causes
PUD, caustic, post-surgical
06Action Endoscopic Dilation
Serial balloon dilation
- 15-20mm target
- 70-80% success for PUD
07End Follow-up Care
Nutrition support, surveillance
08Action Surgical - Benign
Pyloroplasty or GJ
- Laparoscopic gastrojejunostomy
- Antrectomy if refractory
- Path rejoins step 07Shared downstream outcome
09Action Malignant Causes
Gastric, pancreatic, duodenal CA
10Action Resectable
Oncologic resection
- Staging workup first
- Neoadjuvant if indicated
- Path rejoins step 07Shared downstream outcome
11Action Palliation
Stent or bypass
- SEMS for short life expectancy
- Surgical GJ if stent not feasible
- Path rejoins step 07Shared downstream outcome
Guideline Source
SAGES Guidelines for Gastric Outlet Obstruction
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Distinguishing benign from malignant requires adequate tissue sampling
- Stent migration and obstruction are common complications
- Nutritional optimization critical before any intervention
Applicable Regions
USAUUKEU
UK: AUGIS upper GI surgery guidelines
US: SAGES guidelines standard
Version 1Next review: 2028-01-01
Next steps
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Related Resources
Frequently Asked Questions
What is the Gastric Outlet Obstruction Management?
The Gastric Outlet Obstruction Management is a management clinical algorithm for Upper GI Surgery. It provides a structured decision tree to guide clinical decision-making, based on SAGES Guidelines for Gastric Outlet Obstruction.
What guideline is the Gastric Outlet Obstruction Management based on?
This algorithm is based on SAGES Guidelines for Gastric Outlet Obstruction (DOI: 10.1007/s00464-020-07472-2).
What are the limitations of the Gastric Outlet Obstruction Management?
Known limitations include: Distinguishing benign from malignant requires adequate tissue sampling; Stent migration and obstruction are common complications; Nutritional optimization critical before any intervention. Individual patient factors may require deviation from these recommendations.
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