{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:50:08Z","timestamp":1782903008196,"version":"3.54.5"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Background\u2002Endoscopic ultrasound (EUS)-guided gallbladder drainage (GBD) and EUS-guided choledochoduodenostomy (CDS) with lumen-apposing metal stents are alternative approaches to endoscopic retrograde cholangiopancreatography. We compared EUS-GBD and EUS-CDS as first-line therapies in the management of distal malignant biliary obstruction (MBO).<\/jats:p><jats:p>\n               Methods\u2002This was an international, multicenter, retrospective, observational study at 28 tertiary care centers from April 2017 to August 2024.\u200aOutcomes were compared using propensity score matching. The primary outcome was clinical success. Secondary outcomes included technical success, adverse events, and overall survival.<\/jats:p><jats:p>\n               Results\u2002291 patients (mean age 74 [SD 12] years; 130 male) underwent EUS-guided drainage (82 EUS-GBD, 209 EUS-CDS). Most patients developed distal MBO from pancreatic cancer (84\u200a%). After 1-to-1 propensity score matching, 154 patients were selected (77 per group). EUS-GBD and EUS-CDS had similar rates of technical success (96\u200a% [95\u200a%CI 89\u200a%\u201399\u200a%] vs. 99\u200a% [95\u200a%CI 92\u200a%\u201399\u200a%]; P\u200a=\u200a0.36) and clinical success (86\u200a% [95\u200a%CI 75\u200a%\u201392\u200a%] vs. 92\u200a% [95\u200a%CI 83\u200a%\u201397\u200a%]; P\u200a=\u200a0.17), respectively. Overall, 11 patients (14.2\u200a% [95\u200a%CI 7\u200a%\u201324\u200a%]) in each group experienced an adverse event, of which 6 in each group (8\u200a% [95\u200a%CI 2\u200a%\u201316\u200a%]) were serious.<\/jats:p><jats:p>\n               Conclusion\u2002Our study showed that in patients with distal MBO, the use of EUS-GBD or EUS-CDS were comparable, with similar rates of efficacy and safety. EUS-GBD could represent an easy and safe option in patients with DMBO without previous cholecystectomy and with clear patency of the cystic duct.<\/jats:p>","DOI":"10.1055\/a-2650-5492","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:03:32Z","timestamp":1753229012000},"source":"Crossref","is-referenced-by-count":7,"title":["Endoscopic ultrasound-guided gallbladder versus bile duct drainage for first-line therapy of malignant biliary obstruction: international multicenter trial"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-7448","authenticated-orcid":false,"given":"Benedetto","family":"Mangiavillano","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy"},{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital \u2013 IRCCS, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl","family":"Ramai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women\u2019s Hospital, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0485-4903","authenticated-orcid":false,"given":"Alessandro","family":"Fugazza","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital \u2013 IRCCS, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3440-4981","authenticated-orcid":false,"given":"Gianluca","family":"Franchellucci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital \u2013 IRCCS, Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital \u2013 IRCCS, Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Barbera","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini, Teramo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6692-7720","authenticated-orcid":false,"given":"Paolo Giorgio","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and EUS division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8758-654X","authenticated-orcid":false,"given":"Germana","family":"De Nucci","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense, Garbagnate Milanese, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4025-6735","authenticated-orcid":false,"given":"Bel\u00e9n","family":"Mart\u00ednez-Moreno","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Digestive Diseases, Hospital General Universitario de Alicante; Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL), Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Di Mitri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, ARNAS Civico \u2013 Di Cristina \u2013 Benfratelli Hospital, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Therapeutic GI Endoscopy Unit, Campus Bio-Medico University Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Larghi","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Universita\u2019 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2434-3369","authenticated-orcid":false,"given":"Carlos","family":"Robles Medranda","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, University Hospital Omni, Guayaquil, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Anderloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-3103","authenticated-orcid":false,"given":"Luca","family":"De Luca","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology and Digestive Endoscopy, ASST Santi Paolo e Carlo, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-8035","authenticated-orcid":false,"given":"Anthony Y. B.","family":"Teoh","sequence":"additional","affiliation":[{"name":"Surgery, Prince of Wales Hospital, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9623-1389","authenticated-orcid":false,"given":"Jorge","family":"Vargas-Madrigal","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Enrique Baltodano Briceno Hospital, Liberia, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Forti","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy, Ospedale Niguarda-Ca\u2019 Granda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2039-5022","authenticated-orcid":false,"given":"Michiel","family":"Bronswijk","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Bertani","sequence":"additional","affiliation":[{"name":"Gastroenterologia ed Endoscopia Digestiva Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4497-9209","authenticated-orcid":false,"given":"Sundeep","family":"Lakhtakia","sequence":"additional","affiliation":[{"name":"Medical Gastroenterology, AIG Hospitals, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-1680","authenticated-orcid":false,"given":"Khanh","family":"Do-Cong Pham","sequence":"additional","affiliation":[{"name":"Medicine, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Francesco","family":"Crin\u00f2","sequence":"additional","affiliation":[{"name":"Gastroenterology, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital \u2013 IRCCS, Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Section of Gastroenterology, University of Salento, Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Biliary Therapeutic EUS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1097\/MEG.0000000000001752","article-title":"Endoscopic drainage in patients with malignant extrahepatic biliary obstruction: when and how","volume":"32","author":"B Mangiavillano","year":"2020","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1055\/a-0749-8767","article-title":"Performance measures for ERCP and endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative","volume":"50","author":"D Domagk","year":"2018","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/0002-9610(85)90129-1","article-title":"Percutaneous transhepatic cholangiography, drainage, and biopsy in patients with malignant biliary obstruction. An alternative to surgery","volume":"150","author":"D R Voegeli","year":"1985","journal-title":"Am J Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S1089-2516(01)90026-5","article-title":"Complications of percutaneous transhepatic biliary interventions","volume":"4","author":"A B Winick","year":"2001","journal-title":"Tech Vasc Interv Radiol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/a-1717-1391","article-title":"Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"54","author":"S W van der Merwe","year":"2022","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/den.13428","article-title":"Lumen-apposing metal stents for endoscopic ultrasonography-guided interventions","volume":"31","author":"J Y Bang","year":"2019","journal-title":"Dig Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1053\/j.gastro.2023.04.016","article-title":"EUS-guided choledocho-duodenostomy using lumen apposing stent versus ERCP with covered metallic stents in patients with unresectable malignant distal biliary obstruction: a multicenter randomized controlled trial (DRA-MBO trial)","volume":"165","author":"A YB Teoh","year":"2023","journal-title":"Gastroenterology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1053\/j.gastro.2023.07.024","article-title":"Endoscopic ultrasound-guided biliary drainage of first intent with a lumen-apposing metal stent vs endoscopic retrograde cholangiopancreatography in malignant distal biliary obstruction: a multicenter randomized controlled study (ELEMENT trial)","volume":"165","author":"Y-I Chen","year":"2023","journal-title":"Gastroenterology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/j.dld.2024.08.053","article-title":"Primary drainage of distal malignant biliary obstruction: a comparative network meta-analysis","volume":"56","author":"G Lauri","year":"2024","journal-title":"Dig Liver Dis"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1055\/a-2544-6325","article-title":"Impact of endoscopic ultrasound-guided biliary drainage on the management of difficult biliary cannulation in patients with distal malignant biliary obstruction","author":"M Spadaccini","year":"2025","journal-title":"Endoscopy"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1055\/a-2134-3537","article-title":"Endoscopic ultrasound-guided choledochoduodenostomy using single-step lumen-apposing metal stents for primary drainage of malignant distal biliary obstruction (SCORPION-p): a prospective pilot study","volume":"56","author":"J A Fritzsche","year":"2024","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.10.012","article-title":"Optimizing EUS-guided choledochoduodenostomy with lumen-apposing metal stents for primary drainage of malignant distal biliary obstruction (SCORPION-IIp): a prospective pilot study","author":"J A Fritzsche","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1055\/a-1259-0349","article-title":"Endoscopic ultrasound-guided gallbladder drainage as a rescue therapy for unresectable malignant biliary obstruction: a multicenter experience","volume":"53","author":"D Issa","year":"2021","journal-title":"Endoscopy"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1055\/a-2463-1601","article-title":"Stent misdeployment and factors associated with failure in endoscopic ultrasound-guided choledochoduodenostomy: analysis of the combined datasets from two randomized trials","volume":"57","author":"Y-I Chen","year":"2025","journal-title":"Endoscopy"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"E1801","DOI":"10.1055\/a-1526-1208","article-title":"Common bile duct size in malignant distal obstruction and lumen-apposing metal stents: a multicenter prospective study","volume":"9","author":"M Rimba\u015f","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/den.14445","article-title":"Classification, risk factors, and management of lumen apposing metal stent dysfunction during follow-up of endoscopic ultrasound-guided choledochoduodenostomy: multicenter evaluation from the Leuven-Amsterdam-Milan Study Group","volume":"35","author":"G Vanella","year":"2023","journal-title":"Dig Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.gie.2016.01.015","article-title":"Cystic duct patency in EUS-guided gallbladder drainage as a rescue treatment for malignant biliary obstruction","volume":"83","author":"Y Nakai","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"947","DOI":"10.3748\/wjg.v26.i9.947","article-title":"Clinical utility of treatment method conversion during single-session endoscopic ultrasound-guided biliary drainage","volume":"26","author":"K Minaga","year":"2020","journal-title":"World J Gastroenterol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.gie.2020.09.040","article-title":"Comparison of EUS-guided endoscopic transpapillary and percutaneous gallbladder drainage for acute cholecystitis: a systematic review with network meta-analysis","volume":"93","author":"A Podboy","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.gie.2015.12.024","article-title":"EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP","volume":"84","author":"H Imai","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"70","DOI":"10.3748\/wjg.v30.i1.70","article-title":"Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage","volume":"30","author":"A Fugazza","year":"2024","journal-title":"World J Gastroenterol"},{"key":"ref22","first-page":"103","article-title":"Effectiveness of endoscopic ultrasound (EUS)-guided choledochoduodenostomy vs","volume":"37","author":"A Debourdeau","year":"2025","journal-title":"EUS-guided gallbladder drainage for jaundice in patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography: retrospective, multicenter study (GALLBLADEUS Study). Dig Endosc"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/den.14606","article-title":"Endoscopic ultrasound-guided gallbladder drainage as a first approach for jaundice palliation in unresectable malignant distal biliary obstruction: prospective study","volume":"36","author":"B Mangiavillano","year":"2024","journal-title":"Dig Endosc"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.3390\/diagnostics13213341","article-title":"The use of a new dedicated electrocautery lumen-apposing metal stent for gallbladder drainage in patients with acute cholecystitis","volume":"13","author":"L Brandaleone","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"413","DOI":"10.3390\/diagnostics14040413","article-title":"EUS-guided gallbladder drainage using a lumen-apposing metal stent for acute cholecystitis: results of a nationwide study with long-term follow-up","volume":"14","author":"C Binda","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.gie.2021.11.038","article-title":"Novel classification for adverse events in GI endoscopy: the AGREE classification","volume":"95","author":"K J Nass","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1002\/sim.3150","article-title":"A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003","volume":"27","author":"P C Austin","year":"2008","journal-title":"Stat Med"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"P C Austin","year":"2011","journal-title":"Multivariate Behav Res"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1016\/j.gie.2024.03.026","article-title":"American Society for Gastrointestinal Endoscopy guideline on the role of therapeutic EUS in the management of biliary tract disorders: methodology and review of evidence","volume":"100","author":"N B Marya","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.gie.2023.06.054","article-title":"EUS-guided gallbladder drainage using a lumen-apposing metal stent as rescue treatment for malignant distal biliary obstruction: a large multicenter experience","volume":"98","author":"C Binda","year":"2023","journal-title":"Gastrointest Endosc"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.gie.2021.07.021","article-title":"Safety and efficacy of a novel electrocautery-enhanced lumen-apposing metal stent in interventional EUS procedures (with video)","volume":"95","author":"B Mangiavillano","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1055\/a-2219-3179","article-title":"Lumen-apposing metal stents for the treatment of pancreatic and peripancreatic fluid collections and bleeding risk: a propensity matched study","volume":"56","author":"B Mangiavillano","year":"2024","journal-title":"Endoscopy"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2650-5492.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:03:47Z","timestamp":1753229027000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2650-5492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,22]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1055\/a-2650-5492","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,22]]}}}