{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:35:41Z","timestamp":1791095741830,"version":"4.1.0"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000035","name":"Institute of Nutrition, Metabolism and Diabetes","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000035","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Stent misdeployment (SMD) is a feared and poorly characterized technical challenge of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) using lumen-apposing stents. We aimed to ascertain the rate of stent misdeployment in EUS-CDS for malignant distal biliary obstruction (MDBO) and describe its outcomes while identifying variables associated with its occurrence.<\/jats:p><jats:p>\n          Method\u2002This was a post hoc analysis of two randomized controlled trials comparing EUS-CDS vs. endoscopic retrograde cholangiopancreatography in MDBO. The primary end point was rate of SMD, classified as misdeployment of the distal flange (type I), proximal flange (type II), contralateral bile duct wall injury (type III), or double mucosal puncture (type IV). Multivariable analysis was performed to identify variables associated with SMD and\/or technical failure, and with clinical failure or stent dysfunction.<\/jats:p><jats:p>\n          Results\u2002152 patients were included. Technical success was 93.4\u200a%. SMD occurred in 11 patients (7.2\u200a%; 95\u200a%CI 3.1\u200a%\u201311.4\u200a%): 8 type I, 1 type II, and 2 type III. Endoscopic salvage of SMD was successful in 81.8\u200a%. Misdeployment led to adverse events in four patients (two mild, two moderate), giving an overall SMD-related adverse event rate of 2.6\u200a% (95\u200a%CI 0.7\u200a%\u20136.6\u200a%). On multivariable analysis, extrahepatic bile duct diameter of \u2264\u200a15\u200amm was associated with increased odds of SMD and\/or technical failure.<\/jats:p><jats:p>\n          Conclusion\u2002SMD was relatively common in EUS-CDS and was associated with an extrahepatic bile duct diameter of \u2264\u200a15\u200amm. The majority of misdeployments could be rescued endoscopically with low risk for adverse events.<\/jats:p>","DOI":"10.1055\/a-2463-1601","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:02:57Z","timestamp":1730937777000},"page":"330-338","source":"Crossref","is-referenced-by-count":17,"title":["Stent misdeployment and factors associated with failure in endoscopic ultrasound-guided choledochoduodenostomy: analysis of the combined datasets from two randomized trials"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5704-2226","authenticated-orcid":false,"given":"Yen-I","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Long","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand V.","family":"Sahai","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5866-8132","authenticated-orcid":false,"given":"Bertrand","family":"Napoleon","sequence":"additional","affiliation":[{"name":"Hopital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0645-1710","authenticated-orcid":false,"given":"Gianfranco","family":"Donatelli","sequence":"additional","affiliation":[{"name":"Unit\u00e9 d\u2019Endoscopie Interventionnelle, H\u00f4pital Priv\u00e9 des Peupliers, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rastislav","family":"Kunda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"},{"name":"Department of Gastroenterology-Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"},{"name":"Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium"},{"name":"Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Martel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6280-4176","authenticated-orcid":false,"given":"Shannon M.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6692-7720","authenticated-orcid":false,"given":"Paolo G.","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, St-Paul Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5798-9217","authenticated-orcid":false,"given":"Pradermchai","family":"Kongkam","sequence":"additional","affiliation":[{"name":"Division of Hospital and Ambulatory Medicine and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-3908","authenticated-orcid":false,"given":"Nauzer","family":"Forbes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Larghi","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Mosko","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, St-Michael\u2019s Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schalk","family":"Van der Merwe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng Ian","family":"Gan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Vancouver General Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremie","family":"Jacques","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dupuytren University Hospital, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Kenshil","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thawee","family":"Ratanachu-Ek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rajavithi Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Jewish General Hospital, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Royal Prince Alfred Hospital, Sidney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Desilets","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, H\u00f4pital Charles-Le Moyne, Longeuil, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8393-2086","authenticated-orcid":false,"given":"Gurpal","family":"Sandha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Alrifae","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-8035","authenticated-orcid":false,"given":"Anthony Y. 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