{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:23:11Z","timestamp":1790720591378,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Endoscopic ultrasound\u2010guided gallbladder drainage (EUS\u2010GBD) with a lumen\u2010apposing metallic stent is advised for frail patients with acute cholecystitis. However, concerns remain about severe tissue reactions and potential negative impacts on subsequent surgery. EUS\u2010GBD using a double\u2010pigtail plastic stent (DPPS) is an alternative for these patients. However, multiple steps harbor bile or air leaking from the anastomosis site. Some DPPS systems comprise an inner sheath that mounts a DPPS and a delivery pusher catheter. This DPPS system gains a lavage function, similar to a long plastic irrigation tube, when the inner sheath is retracted to the \u201chalfway back position\u201d within the DPPS. This single\u2010arm retrospective study reviewed the active gallbladder lavage technique using this \u201chalfway back position\u201d of the DPPS system during EUS\u2010GBD for patients with acute cholecystitis who left the option of laparoscopic cholecystectomy (Lap\u2010C) as a final option, depending on clinical and performance status recovery. The technical success rate was 97.3% (36\/37). The clinical success rate among those with technical success was 100% (36\/36). The median total duration was 25\u00a0min 7 s, which included a lavage duration of 8\u00a0min 18 s. The volume of lavage was 40\u00a0mL, and the number of attempts was two. The length of the anastomosis measured using computed tomography was 11.6\u00a0mm. No adverse events were reported. Nine patients (25.0%) were scheduled for elective Lap\u2010C, and none required conversion to open surgery. The active gallbladder lavage technique using the DPPS system during EUS\u2010GBD was both feasible and acceptable.<\/jats:p>","DOI":"10.1002\/deo2.70247","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:55:48Z","timestamp":1763463348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Active Gallbladder Lavage Using a Double\u2010pigtail Plastic Stent Delivery System During Endoscopic Ultrasound\u2010guided Gallbladder Drainage (With Video)"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8823-1476","authenticated-orcid":false,"given":"Tesshin","family":"Ban","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Gamagori City Hospital  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of 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