{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:34:01Z","timestamp":1791894841121,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepaticogastrostomy drainage through endoscopic ultrasound (EUS\u2010HGS) has emerged in the 2010s as a new technique for biliary decompression in cases of endoscopic retrograde cholangiopancreatography (ERCP) failure for malignant biliary obstruction (MBO). Substantial technical and procedural progress in performing EUS\u2010HGS has been achieved, allowing high technical and clinical success and an acceptable risk of adverse events in studies mainly focusing on short\u2010term outcomes. However, the long\u2010term effects of EUS\u2010HGS and the risk of recurrent biliary obstruction (RBO) have not been fully evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the long\u2010term effects of EUS\u2010HGS and the risk of RBO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 211 patients undergoing technically successful EUS\u2010HGS in three academic centers were retrospectively collected. Clinical success, adverse events, RBO, and reinterventions were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 198 patients underwent technically successful EUS\u2010HGS for MBO. The median overall survival was 144\u00a0days [108, 2011] after the procedure. Mean patient age was 69.39 (12.91) years. The cause of MBO was pancreatic cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a098, 49.5%) followed by cholangiocarcinoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a029, 14.6%). The location of MBO was distal in 27.6% of cases and proximal in 68.4%. Adverse events were observed during the follow\u2010up in 65 patients (33%). On multivariate analysis, the use of partially covered self\u2010expandable metal stents (PCSEMS) was associated with a lower risk of RBO (HR\u00a0=\u00a00.47 [0.24\u20130.95],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.034). Additionally, patients with distal stenoses had a trend toward better stent patency (HR\u00a0=\u00a00.06[0\u20140.77],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.031). RBO developed in 38 cases (19.1%) mainly due tumor ingrowth (36.8%) with a high success rate of endoscopic management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While RBO occurred in a notable proportion of patients, the primary cause of mortality was progression of the underlying malignancy rather than stent dysfunction. The efficiency of stents, particularly PCSEMS, and the high success rate of endoscopic management for RBO underscore the effectiveness and reliability of these treatments in managing biliary complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12552","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T11:33:00Z","timestamp":1712316780000},"page":"1044-1055","source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010term outcomes of endoscopic ultrasound\u2010guided hepaticogastrostomy in patients with malignant biliary obstruction"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6389-828X","authenticated-orcid":false,"given":"Abdellah","family":"Hedjoudje","sequence":"first","affiliation":[{"name":"Service d'Endoscopie Digestive Hopital Beaujon, Assistance Publqiue des h\u00f4pitaux de Paris  Clichy 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