{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:29:31Z","timestamp":1787632171564,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"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":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Malignant hilar biliary obstruction (MHBO) remains challenging for biliary decompression. Although endoscopic ultrasound\u2010guided biliary drainage (EUS\u2010BD) has emerged as an alternative to endoscopic retrograde cholangiopancreatography\u2010guided BD (ERCP\u2010BD), evidence regarding EUS\u2010BD for MHBO is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of EUS\u2010BD for MHBO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included patients with MHBO who underwent EUS\u2010BD at 12 tertiary referral centers between 2012 and 2023. Technical success, clinical success, and procedure\u2010related adverse events (AEs) were assessed. Multivariable analysis was performed to identify factors associated with clinical failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 141 patients were included. EUS\u2010BD was performed as primary drainage in 67 patients (47.5%) and as rescue drainage after prior ERCP\u2010BD in 74 patients (52.5%); in rescue cases, the reported configurations represented only the EUS\u2010BD component. The overall technical success rate was 98.5% (139\/141). Clinical success was achieved in 87.1% (121\/139). Among patients who achieved clinical success, the median time to recurrent biliary obstruction was 201 days. Procedure\u2010related AE occurred in 15 patients (10.6%). Multivariable analysis identified Bismuth type IV strictures (odds ratio [OR], 5.89; 95% confidence interval [95% CI], 1.72\u201324.3) and EUS\u2010BD drainage limited to one or two liver segments (OR, 5.11; 95% CI, 1.49\u201321.2) as factors associated with clinical failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EUS\u2010BD is a highly feasible and relatively safe option for BD of MHBO in both primary and rescue settings. Bismuth type IV strictures and EUS\u2010BD drainage limited to one or two liver segments were associated with clinical failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>N\/A<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70413","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:12:48Z","timestamp":1787631168000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Endoscopic Ultrasound\u2010Guided Biliary Drainage in the Management of Malignant Hilar Biliary Obstruction: A Multicenter Retrospective Cohort Study"],"prefix":"10.1002","volume":"7","author":[{"given":"Takuji","family":"Iwashita","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"},{"name":"First Department of Internal Medicine Gifu University Hospital  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nagoya City University East Medical Center Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Toyama Prefectural Central Hospital  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Niigata Prefectural Central Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahisa","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Aichi Medical University Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Shioji","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Niigata Cancer Center Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Gifu Municipal Hospital  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Maruta","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital  Gifu Japan"},{"name":"Department of Gastroenterology Gifu Prefectural General Medical Center  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kurobe City Hospital  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002190"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.12.035"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1055\/a-1195-8197","article-title":"ERCP plus Endoscopic Ultrasound\u2010guided Biliary Drainage versus Percutaneous Transhepatic Biliary Drainage for Malignant Hilar Biliary Obstruction: A Multicenter Observational Open\u2010label Study","volume":"53","author":"Kongkam P.","year":"2021","journal-title":"Endoscopy"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.14740\/gr2046"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328\u2010014\u20100467\u20105"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.70194"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.70048"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.70010"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14927"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/a-1717-1391","article-title":"Therapeutic Endoscopic Ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"54","author":"Merwe S. W.","year":"2022","journal-title":"Endoscopy"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.gie.2024.03.027","article-title":"American Society for Gastrointestinal Endoscopy Guideline on the Role of Therapeutic EUS in the Management of Biliary Tract Disorders: Summary and Recommendations","volume":"100","author":"ASoP C.","year":"2024","journal-title":"Gastrointestinal Endoscopy"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010017\u20105553\u20106"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13437"},{"key":"e_1_2_12_16_1","first-page":"72","article-title":"Endoscopic Ultrasound\u2010guided Biliary Drainage for Right Hepatic Bile Duct Obstruction: Novel Technical Tips","volume":"47","author":"Ogura T.","year":"2015","journal-title":"Endoscopy"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X17702614"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.06.055"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2018.094"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:12:50Z","timestamp":1787631170000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70413"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70413","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"assertion":[{"value":"2026-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70413"}}