{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:26:56Z","timestamp":1782836816969,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Early obstruction of a self\u2010expandable metal stent placed for distal malignant biliary obstruction is more likely to occur in the presence of duodenal invasion. An anti\u2010reflux self\u2010expandable metal stent (ARMS) has been developed for the purpose of preventing duodenal fluid reflux into the bile duct. In this study, we evaluated the usefulness and safety of a duckbill\u2010type ARMS (D\u2010ARMS) in the situation of duodenal invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 10 consecutive patients who received D\u2010ARMS for distal malignant biliary obstruction with duodenal invasion. We evaluated non\u2010occlusion cholangitis, recurrent biliary obstruction (RBO), and adverse events after D\u2010ARMS placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no cases of non\u2010occlusion cholangitis. RBO was observed in 2 patients (20%), and time to RBO was 236 days and 117 days, respectively. The causes of RBO were overgrowth and sludge formation. The median time to RBO was 382 days (range, 117\u2013382 days). Only one adverse event was observed (cholecystitis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D\u2010ARMS shows potential as an optimal ARMS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/deo2.103","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T10:05:22Z","timestamp":1646820322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Usefulness of duckbill\u2010type anti\u2010reflux self\u2010expandable metal stents for distal malignant biliary obstruction with duodenal invasion: A pilot study"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8332-9455","authenticated-orcid":false,"given":"Ikuhiro","family":"Kobori","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasumi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Endoscopy Center, Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuki","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Kuwada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Gyotoku","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Kitahama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Tamano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.305"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.512"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-125062"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2002.125366"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-870131"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-006-0012-x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.12.054"},{"key":"e_1_2_9_9_1","first-page":"1903","article-title":"Bridging across the ampulla with metal stents: Evidences for intestinal bile reflux","volume":"60","author":"Wen F","year":"2013","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.04.046"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-011-0409-2"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/2303-9027.117771"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2585-9"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12729"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2017.1382567"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.08.048"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2012.01324.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2012.01382.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12112"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1364872"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000149"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.08.084"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13381"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12379"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966327"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3805173"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.818"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13827"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1216-1220"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1201-3045"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.966"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1034"},{"key":"e_1_2_9_33_1","first-page":"269","article-title":"Endoscopic removal of laser\u2010cut covered self\u2010expandable metallic biliary stents: A report of six cases","volume":"8","author":"Tanisaka Y","year":"2018","journal-title":"Mol Clin Oncol"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1149-1700"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3062-1"},{"key":"e_1_2_9_36_1","first-page":"156","article-title":"Comparison of the clinical impact of endoscopic ultrasound\u2010guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction","volume":"48","author":"Ogura T","year":"2016","journal-title":"Endoscopy"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.103","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.103","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T13:15:04Z","timestamp":1692882904000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,9]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/deo2.103"],"URL":"https:\/\/doi.org\/10.1002\/deo2.103","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,9]]},"assertion":[{"value":"2021-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e103"}}