Collaborative International Research Evaluates Important Treatment Approach for Pancreatic Cancer

World-class research is foundational to the Orlando Health Digestive Health Institute’s strength as a global leader in digestive disease. Since its inception in 2022, the institute has concluded several high-quality clinical trials and published more than 100 peer-reviewed manuscripts.

“Our aim is to pioneer the most effective treatment options that are also the least invasive in order to provide the best outcomes for patients with complex digestive diseases,” says Shyam S. Varadarajulu, MD, president of Orlando Health Digestive Health Institute and an internationally renowned expert in gastroenterology. “Our faculty team includes outstanding clinical investigators who are ideally geared for this type of cutting-edge research.”

Most recently, the Center for Advanced Endoscopy, Research and Education (CARE) at Orlando Health Digestive Health Institute published findings of a path-breaking clinical trial in GUT that is likely to positively impact the clinical management of patients with pancreatic cancer Endoscopic or surgical gastroenterostomy for malignant gastric outlet obstruction (GOOSE Trial) is the first multicenter, randomized clinical trial comparing endoscopic ultrasound-guided gastroenterostomy (EUS-GE) and surgical gastrojejunostomy (SGJ) for the treatment of malignant gastric outlet obstruction (GOO), mostly in patients with pancreatic cancer.

Led by principal investigator Ji Young Bang, MD, interventional endoscopist and director of clinical research at Orlando Health Digestive Health Institute, the trial investigated EUS-GE as a new, less invasive approach to SGJ.

Between September 16, 2022, and November 24, 2024, this international trial successfully randomized 74 patients with malignant gastric outlet obstruction to compare both methods. Sites included Orlando Health; West Virginia University in Morgantown; RUSH University in Chicago; Asian Institute of Gastroenterology in Hyderabad, India; Medanta Medical Center in New Delhi, India; and the University of Hamburg in Germany.

The study observed that an endosonographic approach was significantly superior to surgical gastrojejunostomy with regards to early resumption of solid diet intake, less need for reinterventions or supplemental nutrition, shorter length of hospitalization, early initiation or resumption of chemotherapy, better health-related quality of life for physical and social functioning and lower treatment costs.

With the rising incidence of pancreatic cancer worldwide and approximately 20% of patients developing gastric outlet obstruction during illness, the study findings suggest that EUS-guided gastroenterostomy should be the preferred treatment approach when the requisite expertise and resources are available. 

To access the video commentary from multidisciplinary experts on study findings, click here.

Orlando Health Digestive Health Institute is a referral center of excellence committed to furthering research and clinician education about the most advanced, complex digestive disorders. The institute’s internationally recognized physicians combine comprehensive and coordinated tertiary care with innovative clinical research to advance the study and treatment of digestive diseases.