Management of Malignant Gastric Outlet Obstruction Between Surgery and Endoscopy

Inclusion Criteria: * 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 Exclusion Criteria: * 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 informed consent form (ICF) * contraindications to any active palliation of the mGOO, or indication to palliation through venting gastrostomy or nasogastric tube placement alone