{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:07:26Z","timestamp":1788941246004,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":123,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20232BAB216016"],"award-info":[{"award-number":["20232BAB216016"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to compare the clinical outcomes of the bent guidewire insertion (BGI) technique and the conventional straight guidewire insertion (SGI) technique for managing\u00a0recurrent malignant biliary obstruction (RMBO) after initial uncovered metallic stent (UMS) placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety patients who underwent endoscopic intervention for RMBO after UMS placement were retrospectively included. Clinical outcomes and endoscopic retrograde cholangiopancreatography (ERCP)\u2010related factors were compared between the SGI and BGI groups. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors associated with difficult cannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 43 and 47 patients who underwent the SGI and BGI techniques, respectively, for intervention of RMBO. The SGI group had significantly higher rates of difficult cannulation (48.8% vs. 19.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and guidewire insertion technique transformation (44.2% vs. 4.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, procedure time (49.7\u2009min\u2009\u00b1\u200923.4\u2009min vs. 34.7\u2009min\u2009\u00b1\u200920.5\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and cannulation time (5.0\u2009min vs. 4.0\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) were longer in the SGI group. Technical and clinical success rates, procedure\u2010related complications, and length of hospitalization were comparable between the two groups. Multivariate analysis revealed that SGI (odds ratio [OR] 4.682, 95% confidence interval [CI] 1.643\u201313.340,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and hilar biliary tract lesions (OR 3.673, 95% CI 1.236\u201310.915,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) were identified as independent factors for difficult biliary cannulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BGI technique may be superior to SGI approach for re\u2010intervention in patients with RMBO after initial UMS placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1751-2980.70065","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:36:13Z","timestamp":1788255373000},"page":"243-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Different Guidewire\u2010Assisted Techniques for Recurrent Malignant Biliary Obstruction After Uncovered Metallic Stent Placement"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6717-0125","authenticated-orcid":false,"given":"Qiao Feng","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6249-8276","authenticated-orcid":false,"given":"Zi Hang","family":"Xu","sequence":"additional","affiliation":[{"name":"Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You Hua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen Zhen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Wei","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-6133","authenticated-orcid":false,"given":"You Xiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Jiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Bo","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College Nanchang University  Nanchang Jiangxi Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.12.035"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0659-9864"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2025.12.031"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/postmj\/qgae165"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl210228"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11020086"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.10.023"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.05.022"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14260"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.11.017"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-108641"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl19304"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000002268"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v4.i8.213"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272918"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"issue":"1","key":"e_1_2_9_18_1","first-page":"105","article-title":"Predictors of Postendoscopic Retrograde Cholangiopancreatography Associated Cholangitis: A Retrospective Cohort Study","volume":"52","author":"Y\u0131lmaz H.","year":"2022","journal-title":"Turkish Journal of Medical Sciences"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-102250"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.136"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.15060"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1075-4080"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002190"}],"container-title":["Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.70065","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1751-2980.70065","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.70065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:57:53Z","timestamp":1788940673000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1751-2980.70065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":22,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/1751-2980.70065"],"URL":"https:\/\/doi.org\/10.1111\/1751-2980.70065","archive":["Portico"],"relation":{},"ISSN":["1751-2972","1751-2980"],"issn-type":[{"value":"1751-2972","type":"print"},{"value":"1751-2980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}