{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:58:34Z","timestamp":1785851914838,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"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":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate long\u2010term outcomes of endoscopic double stenting using anti\u2010reflux metal stents (ARMS) for combined malignant biliary and duodenal obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with advanced pancreatic cancer who received endoscopic double stenting with self\u2010expandable metal stents (SEMS) for combined malignant biliary and duodenal obstruction at our institution between July 2014 and March 2021 were evaluated. Patients were divided into the ARMS group, endoscopic ultrasound\u2010guided hepaticogastrostomy (EUS\u2010HGS) group, and covered metal stent\u2010transpapillary (CMS\u2010transpapillary) group. A Duckbill\u2010type metal stent was used in all ARMS cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010eight patients were enrolled: ARMS group (n\u00a0=\u00a016), EUS\u2010HGS group (n\u00a0=\u00a013), and CMS\u2010transpapillary group (n\u00a0=\u00a09). Overall survival among three groups were not significantly different. Recurrent biliary obstruction\u00a0(RBO) rates of the ARMS, EUS\u2010HGS, and CMS\u2010transpapillary groups were 12.5%, 61.5%, and 88.9% (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) and median time to recurrent biliary obstructions (TRBOs) were not reached, 125\u2009days, and 7\u2009days (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). Median TRBOs of ARMS\u2010choledochoduodenostomy and ARMS\u2010transpapillary were not statistically different. Major causes of RBO were stent occlusion and symptomatic stent migration in the ARMS group, hyperplasia in the EUS\u2010HGS group, and non\u2010occlusion cholangitis in the CMS\u2010transpapillary group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endoscopic double stenting with ARMS might be an option for combined malignant biliary and duodenal obstruction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1181","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T11:00:11Z","timestamp":1652871611000},"page":"144-152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010term outcomes of endoscopic double stenting using an anti\u2010reflux metal stent for combined malignant biliary and duodenal obstruction"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7109-9835","authenticated-orcid":false,"given":"Takashi","family":"Sasaki","sequence":"first","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8166","authenticated-orcid":false,"given":"Tsuyoshi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinatsu","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-5558","authenticated-orcid":false,"given":"Takafumi","family":"Mie","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyoshi","family":"Kasuga","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Ozaka","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sasahira","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Cancer Registry and Statistics.Cancer Information Service National Cancer Center Japan (Vital Statistics of Japan). 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