{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:45:33Z","timestamp":1767829533892,"version":"3.49.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Cancer Center Research and Development Fund","award":["2022-A-16"],"award-info":[{"award-number":["2022-A-16"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims Endoscopic gastroduodenal stent (GDS) deployment is currently a standard treatment for malignant gastric outlet obstruction (mGOO) in patients with limited life expectancy; however, stent dysfunction (SD) and complicated pancreatitis often occur after GDS deployment. We investigated incidence and contributing factors of SD and complicated pancreatitis.<\/jats:p><jats:p>\n            Patients and methods We retrospectively reviewed 203 patients who underwent initial GDS deployment for palliation of mGOO symptoms between October 2017 and July 2022, including 109 who underwent GDS deployment across the duodenal papilla (sub-cohort).<\/jats:p><jats:p>\n            Results SDs, including tumor ingrowth (n = 26), kinking (n = 14), and migration (n = 13), occurred in 68 patients (33.5%). Cumulative SD incidence was 41.1% (95% confidence interval, 32.6\u201349.4%). SD incidence increased to 0.4%, 0.16%, and 0.06% per day at &lt; 8, 8\u201316, and&gt;16 weeks, respectively. On multivariate analysis, Niti-S pyloric\/duodenal stent deployment (sub-distribution hazard ratio [sHR] 0.26, P = 0.01) and survival length \u2265 90 days (sHR 2.5, P = 0.01) were respectively identified as favorable and risk factors significantly associated with SD. Pancreatitis developed in 14 patients (12.8%) in the sub-cohort, which had significantly higher parenchymal diameter (P &lt; 0.01) and lower main pancreatic duct (MPD) caliber (P &lt; 0.01) than the non-pancreatitis cohort. On multivariate analysis, MPD caliber &lt; 3 mm independently predicted pancreatitis (odds ratio 6.8, P = 0.03).<\/jats:p><jats:p>\n            Conclusions Deployment of the Niti-S pyloric\/duodenal stent, with conformability even for angulated strictures, significantly reduced the incidence of SD. Stent selection, life expectancy, and MPD caliber should be taken into consideration during decision-making for GDS deployment for mGOO.<\/jats:p>","DOI":"10.1055\/a-2261-2833","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T01:05:16Z","timestamp":1707181516000},"page":"E367-E376","source":"Crossref","is-referenced-by-count":4,"title":["Incidence and factors associated with stent dysfunction and pancreatitis after gastroduodenal stenting for malignant gastric outlet obstruction"],"prefix":"10.1055","volume":"12","author":[{"given":"Daiki","family":"Yamashige","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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 Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshikuni","family":"Nagashio","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Maruki","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2907-7776","authenticated-orcid":false,"given":"Soma","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenobu","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daiki","family":"Agarie","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Takasaki","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Chatto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Makati Medical Center, Makati City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Ohba","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chigusa","family":"Morizane","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyuki","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Cancer Center Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Saito","sequence":"additional","affiliation":[{"name":"Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Okusaka","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/j.1572-0241.2002.05391.x","article-title":"Malignant gastric outlet obstruction: bridging another divide","volume":"97","author":"DA Tendler","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1055\/s-2004-814434","article-title":"Self-expanding metal stents for 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stents","volume":"70","author":"H Isayama","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.jvir.2007.02.030","article-title":"Fate of migrated esophageal and gastroduodenal stents: experience in 70 patients","volume":"18","author":"HK Ko","year":"2007","journal-title":"J Vasc Interv Radiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"152","DOI":"10.4329\/wjr.v3.i6.152","article-title":"Small bowel perforation after duodenal stent migration: an interesting case of a rare complication","volume":"3","author":"PH Lee","year":"2011","journal-title":"World J Radiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"E54","DOI":"10.1055\/s-2006-944903","article-title":"A case of small-bowel perforation caused by a migrated duodenal stent","volume":"39","author":"PW Moxey","year":"2007","journal-title":"Endoscopy"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"360","DOI":"10.4261\/1305-3825.DIR.5045-11.1","article-title":"Placement of duodenal stents across the duodenal papilla may predispose to acute pancreatitis: a retrospective analysis","volume":"18","author":"L Shi-Yi","year":"2012","journal-title":"Diagn Interv Radiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1055\/a-1782-7568","article-title":"Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison","volume":"54","author":"RLJ van Wanrooij","year":"2022","journal-title":"Endoscopy"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"3404","DOI":"10.1007\/s00464-018-06636-3","article-title":"EUS-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction","volume":"33","author":"PS Ge","year":"2019","journal-title":"Surg Endosc"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1016\/j.gie.2017.07.030","article-title":"EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques","volume":"87","author":"YI Chen","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.gie.2021.04.006","article-title":"Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score-matched comparison (with video)","volume":"94","author":"M Bronswijk","year":"2021","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International 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