In the Netherlands, yearly approximately 2100 patients are diagnosed with gas- tric cancer, 1500 with pancreatic cancer, 400 with hepatobiliary cancer and 90 with duodenal cancer.1 The median survival of these patients with locally advanced un- resectable disease is 8-12 months and only 3-6 months for those with metastatic disease at presentation.2 Gastric outlet obstruction (GOO) is a common symptom in these patients and it has been found that 10-20% of patients with pancreatic cancer develop GOO.3−5 GOO causes nausea, malnutrition and dehydration, resulting in a poor clinical condition at presentation.5−7 Therefore, palliative treatment of GOO is mandatory as the clinical condition of these patients deteriorates rapidly, with consequently a short survival if left untreated. The aim of palliative treatment is to re-establish oral food intake and stabilize or even improve quality of life of these patients.