{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:45:37Z","timestamp":1785455137180,"version":"3.56.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"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":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>One advantage of endoscopic ultrasound\u2010guided hepaticogastrostomy (EUS\u2010HGS) is that it is difficult for reflux cholangitis, caused by duodenal pressure increasing due to duodenal obstruction, to occur. In addition, since stent deployment is performed away from the malignant stricture site, longer stent patency than with endoscopic retrograde cholangiopancreatography (ERCP) may be obtained. However, no study has previously compared EUS\u2010HGS and ERCP for patients without duodenal obstruction or surgically altered anatomy. The aim of the present study was to compare clinical outcomes between EUS\u2010HGS and ERCP in normal anatomy patients without duodenal obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In the ERCP group, patients who initially underwent biliary drainage were included. In the EUS\u2010HGS group, patients who underwent EUS\u2010HGS due to failed biliary cannulation were included. Patients with an inaccessible papilla, such as with surgically altered anatomy or duodenal obstruction, were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 314 patients who underwent ERCP and EUS\u2010HGS were enrolled in this study. Of the 314 patients, 289 underwent biliary stenting under ERCP guidance, and 25 patients underwent biliary stenting under EUS\u2010HGS. After propensity score\u2010matching analysis, the adverse event rate tended to be lower in the EUS\u2010HGS group than in the ERCP group. Although overall survival was not significantly different between the EUS\u2010HGS and ERCP groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.228), stent patency was significantly longer in the EUS\u2010HGS group (median 366.0\u2009days) than in the ERCP group (median 76.5\u2009days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EUS\u2010HGS had a lower adverse event rate, shorter procedure time, and longer stent patency than ERCP in cases of normal anatomy without duodenal obstruction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.12055","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T07:59:01Z","timestamp":1721289541000},"page":"680-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multicenter study comparing <scp>EUS<\/scp>\u2010guided hepaticogastrostomy and <scp>ERCP<\/scp> for malignant biliary obstruction in patients with accessible papillae"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2916-6568","authenticated-orcid":false,"given":"Takeshi","family":"Ogura","sequence":"first","affiliation":[{"name":"2nd Department of Internal Medicine Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6719-4466","authenticated-orcid":false,"given":"Hirotoshi","family":"Ishiwatari","sequence":"additional","affiliation":[{"name":"Division of Endoscopy Shizuoka Cancer Center  Nagaizumi\u2010cho Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0394-6876","authenticated-orcid":false,"given":"Susumu","family":"Hijioka","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital  Chuo\u2010ku 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