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Background:Gastrojejunostomy (GJJ) and endoscopic stenting (ES) are palliative treatments for gastric outlet obstruction (GOO) caused by gastric cancer.We compared the outcomes of GJJ with ES by performing a meta-analysis.Methods:Clinical trials that compared GJJ with ES for the treatment of GOO in gastric cancer were included in the meta-analysis.Procedure time,time to resumption of oral intake,duration of hospital stay,patency duration,and overall survival days were compared using weighted mean differences (WMDs).Technical success,clinical success,procedure-related mortality,complications,the rate of re-obstruction,postoperative chemotherapy,and reintervention were compared using odds ratios (ORs).Results:Nine studies were included in the analysis.Technical success and clinical success were not significantly different between the ES and GJJ groups.The ES group had a shorter procedure time (WMD =-80.89 min,95％ confidence interval [CI] =-93.99 to-67.78,P ＜ 0.001),faster resumption of oral intake (WMD =-3.45 days,95％ CI=-5.25 to-1.65,P ＜ 0.001),and shorter duration of hospital stay (WMD =-7.67 days,95％ CI =-11.02 to-4.33,P ＜ 0.001).The rate of minor complications was significantly higher in the GJJ group (OR =0.13,95％ CI =0.04-0.40,P ＜ 0.001).However,the rates of major complications (OR =6.91,95％ CI =3.90-12.25,P ＜ 0.001),re-obstruction (OR =7.75,95％ CI =4.06-14.78,P ＜ 0.001),and reintervention (OR =6.27,95％ CI =3.36-11.68,P ＜ 0.001) were significantly lower in the GJJ group than that in the ES group.Moreover,GJJ was significantly associated with a longer patency duration (WMD =-167.16 days,95％ CI =-254.01 to-89.31,P ＜ 0.001) and overall survival (WMD =-103.20 days,95％ CI =-161.49to-44.91,P=0.001).Conclusions:Both GJJ and ES are effective procedures for the treatment of GOO caused by gastric cancer.ES is associated with better short-term outcomes.GJJ is preferable to ES in terms of its lower rate of stent-related complications,re-obstruction,and reintervention.GJJ should be considered a treatment option for patients with a long life expectancy and good performance status.