{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:45:27Z","timestamp":1784335527303,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>We developed EUS\u2010guided double\u2010balloon occluded gastrojejunostomy (EPASS) for gastric drainage tract obstruction. The success of EPASS depends on the proximity of the stomach and the gastrointestinal (GI) tract near the ligament of Treitz. The aim of this study is to clarify the GI anatomy near the ligament of Treitz.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One thousand and sixteen cases imaged upper GI radiography using barium were retrospectively evaluated. Morphologically, the GI tract running near the ligament of Treitz was divided in three types: Type I: The 4th portion of the duodenum (D4) approaches the stomach; Type II: D4 does not approach the stomach; Type III: D4 forms a loop to the jejunum. The minimum distance between the stomach and the GI tract near the ligament of Treitz was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the morphological classification, 74.6% in the study group was classified in Type I, 22.0% in Type II, and 3.3% in Type III, respectively. The median minimum distance in Type II\/III group were significantly longer, compared with the Type I (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The GI anatomy near the ligament of Treitz was clarified using upper GI radiography. It is divided into three patterns, and one\u2010fourth of cases may have difficulty in EUS\u2010guided gastrojejunostomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1018","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T19:28:13Z","timestamp":1624908493000},"page":"1023-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Morphological study of the gastrointestinal tract around the ligament of Treitz using upper gastrointestinal radiography: Fundamental data for EUS\u2010guided gastrojejunostomy"],"prefix":"10.1002","volume":"28","author":[{"given":"Daisuke","family":"Nutahara","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Shinjuku\u2010ku Japan"},{"name":"Department of Gastroenterology and Hepatology Hachioji Medical Center Tokyo Medical University Shinjuku\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1904-6191","authenticated-orcid":false,"given":"Kazumasa","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Shinjuku\u2010ku Japan"},{"name":"Department of Gastroenterology and Hepatology Hachioji Medical Center Tokyo Medical University Shinjuku\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Sofuni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Shinjuku\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2586-0635","authenticated-orcid":false,"given":"Takayoshi","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Shinjuku\u2010ku 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Tokyo Kamata Medical Center Ota\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Shinjuku\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1997.01430260082018"},{"key":"e_1_2_7_3_1","first-page":"241","article-title":"Endolaparoscopic palliation of pancreatic cancer","volume":"2","author":"Mouiel J","year":"1992","journal-title":"Surg Laparosc 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