{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:56:22Z","timestamp":1791366982515,"version":"4.3.1"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"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":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Study Aims<\/jats:title>\n                    <jats:p>Accurate visualization of the duodenal papilla is essential during endoscopic ultrasound (EUS). Water immersion (WI)\u2010EUS improves papillary visibility by expanding the duodenal lumen, but maintaining sufficient water can be difficult. Gel immersion (GI)\u2010EUS offers more stable visualization, though comparative data remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      This dual\u2010center retrospective study included 200 patients who underwent GI\u2010EUS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009101) or WI\u2010EUS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200999) for ampullary evaluation. Archived videos were randomized and independently assessed by two blinded pancreatobiliary EUS experts. Delineation quality was evaluated using predefined parameters: duodenal distension, liquid retention, and artifact reduction. Optimal delineation success was defined as complete scores for all parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GI\u2010EUS achieved a significantly higher optimal delineation success rate than WI\u2010EUS (60.4% vs. 32.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) while requiring less liquid volume (100\u2009mL vs. 150\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariable analysis identified GI as an independent factor associated with delineation success (adjusted OR: 2.83, 95% CI: 1.43\u20135.57). Inter\u2010observer agreement was substantial, and adverse event rates were similarly low between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with WI, GI\u2010EUS significantly improves ampullary delineation with enhanced liquid stability and clarity, supporting clinical utility in pancreatobiliary EUS evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70090","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:23:14Z","timestamp":1772958194000},"page":"499-511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gel Immersion vs. Water Immersion Endoscopic Ultrasound for Visualization of the Duodenal Papilla and Periampullary Lesions: A Dual\u2010Center Retrospective Study With Blinded Evaluation of Archived Videos"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-3665","authenticated-orcid":false,"given":"Haruka","family":"Toyonaga","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"},{"name":"Center for Gastroenterology Teine Keijinkai Hospital  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Kin","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology Teine Keijinkai Hospital  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine Kyoto University  Kyoto 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