{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:03:46Z","timestamp":1791979426908,"version":"4.4.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                  Background\u2002We aimed to determine risk factors for technical failure of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS), evaluate short- and long-term consequences, and identify salvage techniques in patients with biliary obstruction.<\/jats:p><jats:p>\n                  Methods\u2002This retrospective multicenter study of EUS-CDS (2018\u20132024) included technical failure, classified as type 1 (digestive flange mispositioned), type 2 (biliary flange mispositioned), type 3 (stent deployment failure), type 4 (catheter\/lumen-apposing metal stent [LAMS] through the bile duct), and type 5 (others). Controls were successful EUS-CDS in the same center and period. The primary end point was risk factors for failure. Secondary end points were endoscopic rescue techniques and immediate- and long-term consequences.<\/jats:p><jats:p>\n                  Results\u2002Technical failure occurred in 7\u200a% (95\u200a%CI 5\u20139). Across 23 centers, 296 patients were analyzed (mean age 71 [SD 16] years, 53\u200a% male), including 100 technical failures: type 1 (26\u200a%), type 2 (41\u200a%), type 3 (11\u200a%), type 4 (6\u200a%), type 5 (16\u200a%). Risk factors for technical failure in multivariate analysis included CBD diameter \u2264\u200a15\u200amm, duodenal stenosis, wired technique, and low operator experience (\u2264\u200a10 LAMS). Endoscopic salvage was successful in 77\u200a%, with 53\u200a% using a covered metal stent and 22\u200a% using a new LAMS. Early failures were mild in 56\u200a% of cases, but 12\u200a% resulted in death within 30 days. Immediate endoscopic salvage reduced severe clinical adverse events (P\u200a&lt;\u200a0.001) and increased success rates (P\u200a&lt;\u200a0.001).<\/jats:p><jats:p>\n                  Conclusions\u2002EUS-CDS failures were not rare and were severe in half of cases. Recognizing risk factors, identifying failures during the procedure, and knowing endoscopic salvage methods are crucial.<\/jats:p>","DOI":"10.1055\/a-2541-2973","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T19:12:56Z","timestamp":1739819576000},"page":"990-1000","source":"Crossref","is-referenced-by-count":17,"title":["Technical failure of endoscopic ultrasound-guided choledochoduodenostomy: multicenter study on rescue techniques, consequences, and risk factors"],"prefix":"10.1055","volume":"57","author":[{"given":"Clara","family":"Beunon","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Universit\u00e9 Paris Cit\u00e9, Beaujon University Hospital (APHP), Clichy, France"},{"name":"Department of Pancreatology and Digestive Oncology, Universit\u00e9 Paris Cit\u00e9, Beaujon University Hospital (APHP), CRMR PaRaDis Pancreatic Rare Diseases, Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-6948","authenticated-orcid":false,"given":"Antoine","family":"Debourdeau","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, CHU de N\u00eemes, CHU de Montpellier, Montpellier University MUSE, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Hepato-Gastroenterology Department, Nancy Regional University Hospital Center, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timoth\u00e9e","family":"Wallenhorst","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, CHU Rennes, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Perez-Cuadrado-Robles","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Universit\u00e9 Paris Cit\u00e9, Hopital Europ\u00e9en Georges Pompidou (APHP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Belle","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Universit\u00e9 Paris Cit\u00e9, Cochin University Hospital (APHP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-8236","authenticated-orcid":false,"given":"Jean-Michel","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Universit\u00e9 Aix Marseille, H\u00f4pital Nord (APHM), Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2566-3866","authenticated-orcid":false,"given":"Marine","family":"Camus Duboc","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, Universit\u00e9 Sorbonne, Saint Antoine University Hospital (APHP), Paris, 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Sportes","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Institut Arnault Tzanck, Saint Laurent du Var, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Brieau","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Clinique Jules Vernes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Ben Soussan","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Clinique de l\u2019Alma, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Petiet","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Grand H\u00f4pital de l\u2019Est Francilien, Meaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Martin","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, CHU H\u00f4pital Bic\u00eatre (APHP), Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarra","family":"Oumrani","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9rique","family":"Maire","sequence":"additional","affiliation":[{"name":"Department of Pancreatology and Digestive Oncology, Universit\u00e9 Paris Cit\u00e9, Beaujon University Hospital (APHP), CRMR PaRaDis Pancreatic Rare Diseases, Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Lemmers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, HUB (H\u00f4pital Universitaire de Bruxelles), ULB (Universit\u00e9 Libre de Bruxelles), Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Prat","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Universit\u00e9 Paris Cit\u00e9, Beaujon University Hospital (APHP), Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Caillo","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, CHU de N\u00eemes, Montpellier Univ, MUSE, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"G\u00e9rard","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, CHU Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie","family":"Albouys","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, CHU Limoges, Limoges, 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