{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:12:32Z","timestamp":1789524752396,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Although the technique of endoscopic ultrasound\u2010guided choledochoduodenostomy (EUS\u2010CDS) is becoming standardized, its safety issues have not been sufficiently investigated. Therefore, we aimed to identify factors associated with adverse events and stent patency in EUS\u2010CDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients who underwent EUS\u2010CDS between September 2003 and July 2017 were included. Technical\/clinical success, adverse events and stent dysfunctions were analyzed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 151 patients underwent EUS\u2010CDS. In nine patients, procedures were discontinued before puncture. Technical and clinical success rates were 96.5% (137\/142) and 98.5% (135\/137), respectively. The adverse event rate was 20.4% (29\/142). As a risk factor for peritonitis, plastic stents (PS) showed a significantly high odds ratio (OR) compared with covered self\u2010expandable metal stents (CSEMS; OR, 4.31; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.030). CSEMS cases showed a significantly longer patency period than PS cases (329 vs 89\u00a0days; HR, 0.35; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). As a risk factor for early stent dysfunction (within 14\u00a0days), stent direction to the oral side showed a significantly high OR (OR, 43.47; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). In cases with oblique\u2010viewing EUS, double penetration of the duodenum occurred at significantly higher frequency than in cases with forward\u2010viewing EUS (7.0 vs 0.0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plastic stents and stent direction to the oral side were risk factors for peritonitis and early stent dysfunction, respectively. Using covered self\u2010expandable metal stents and changing stent direction to the anal side seemed appropriate to prevent peritonitis and early stent dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.13620","type":"journal-article","created":{"date-parts":[[2019,12,28]],"date-time":"2019-12-28T19:44:10Z","timestamp":1577562250000},"page":"957-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Risk factor analysis for adverse events and stent dysfunction of endoscopic ultrasound\u2010guided choledochoduodenostomy"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-9116","authenticated-orcid":false,"given":"Shimpei","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"},{"name":"Department of Gastroenterology and Hepatology Kyoto University Graduate School of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-6136","authenticated-orcid":false,"given":"Kazuo","family":"Hara","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobumasa","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamichi","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6376-687X","authenticated-orcid":false,"given":"Nozomi","family":"Okuno","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Obata","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"},{"name":"Department of Gastroenterology Kumamoto City Hospital Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kurita","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"},{"name":"Department of Gastroenterology and Hepatology Yokohama City University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Koda","sequence":"additional","affiliation":[{"name":"Departments of Department of Gastroenterology Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Tajika","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiyo","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Toriyama","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasumasa","family":"Niwa","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Aichi Cancer Center Hospital Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"Cd004200","article-title":"Palliative biliary stents for obstructing pancreatic carcinoma","author":"Moss AC","year":"2006","journal-title":"Cochrane Database Syst. 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