{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T23:07:53Z","timestamp":1779232073846,"version":"3.51.4"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients requiring biliary interventions with endoscopically inaccessible papilla or biliodigestive anastomosis represent a challenge in clinical practice. Historically, percutaneous transhepatic biliary drainage (PTBD) has often been the only viable treatment after failed endoscopic attempts. Recently, endoscopic ultrasound (EUS)-guided techniques have emerged as promising alternatives. This study evaluated the feasibility and safety of EUS-guided transenteric ERCP (EDEE) at a tertiary referral center.<\/jats:p>\n                  <jats:p>This retrospective, single-center study included patients who underwent EDEE between February 2020 and November 2025. Primary endpoints were safety and overall technical success, defined as successful creation of an EUS-guided anastomosis (EA) using a lumen-apposing metal stent (LAMS) followed by endoscopic retrograce cholangiopancreatography (ERCP) via LAMS. Secondary endpoints included clinical success, need for reinterventions, and procedure characteristics.<\/jats:p>\n                  <jats:p>A total of 24 patients (70.3 \u00b1 12.6 years; 6 female) were analyzed. Sixteen patients had surgically altered anatomy (5 Whipple, 11 Roux-en-Y), and eight presented with malignant gastric outlet obstruction. EA and ERCP via LAMS were conducted in two stages with a median interval of 29.5 days. In 15 patients, the afferent loop was accessed after filling via a previously placed PTBD, which was removed after EDEE. Technical success was 100% (24\/24) for EA and 87.5% (21\/24) for ERCP via LAMS; overall technical and clinical success were 87.5% (21\/24). Procedure-related complications occurred in two patients (8.3%), including one aspiration pneumonia and one LAMS misplacement.<\/jats:p>\n                  <jats:p>This study suggests that EDEE is a feasible and safe method for biliary drainage in patients with inaccessible biliary anatomy, demonstrating high technical and clinical success in both malignant and benign conditions being performed at a highly specialized tertiary center.<\/jats:p>","DOI":"10.1055\/a-2858-0711","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:05:58Z","timestamp":1776985558000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Endoscopic ultrasound-directed transenteric ERCP in patients with benign and malignant diseases and inaccessible biliary system"],"prefix":"10.1055","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct07096895","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9427-7015","authenticated-orcid":false,"given":"Leonie","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Veiser","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Euler","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Balasus","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Dertmann","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Schneider","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Beyna","sequence":"additional","affiliation":[{"name":"Evangelisches Krankenhaus D\u00fcsseldorf, NRW, Germany","place":["D\u00fcsseldorf"],"department":["Department of Internal Medicine and Gastroenterology"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1055\/a-2481-7048","article-title":"Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"57","author":"A Facciorusso","year":"2025","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1055\/a-0862-0346","article-title":"Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline","volume":"51","author":"G 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