{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:14:01Z","timestamp":1791083641496,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"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":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cholecystitis is a major adverse event after self\u2010expandable metallic stent placement for distal biliary obstruction (DBO). Covered self\u2010expandable metallic stent (CSEMS) is being increasingly used, but few studies have investigated risk factors for cholecystitis limited to CSEMS. The present study aimed to identify risk factors for cholecystitis after CSEMS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent initial CSEMS placement for DBO between November 2014 and September 2021 were enrolled and followed\u2010up until death, recurrent biliary obstruction, cholecystitis, or until March 2022. Cholecystitis within 30\u2009days of CSEMS was defined as early cholecystitis and after 30\u2009days as late cholecystitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cholecystitis occurred in 51 of 339 patients (15%) after CSEMS. Forty\u2010one patients (80.4%) had early cholecystitis, and 10 (19.6%) had late cholecystitis. Multivariate logistic regression analysis revealed that the maximum diameter of the common bile duct (CBD) (per 1\u2009mm increase) (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.76\u20131.00; <jats:italic>p<\/jats:italic>\u2009=\u2009.044), gallbladder stones (OR: 3.63; 95% CI: 1.62\u20138.10; <jats:italic>p<\/jats:italic>\u2009=\u2009.002), and tumor involvement in the cystic duct (CD) (OR: 4.87; 95% CI: 2.16\u201311.00; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were significant independent risk factors associated with early cholecystitis. No significant risk factors were identified for late cholecystitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A smaller CBD diameter, gallbladder stones, and tumor involvement in the CD were identified as risk factors for early cholecystitis development after CSEMS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1350","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T12:15:00Z","timestamp":1694520900000},"page":"1180-1187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk factors for early and late cholecystitis after covered metal stent placement for distal biliary obstruction"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2136-4703","authenticated-orcid":false,"given":"Tatsuya","family":"Ishii","sequence":"first","affiliation":[{"name":"Center for Gastroenterology Teine Keijinkai Hospital  Sapporo 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