{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:12:36Z","timestamp":1788487956550,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"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":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Anti\u2010reflux metal stent (ARMS) has been used to prevent recurrent biliary obstruction (RBO) due to sludge formation or food impaction. However, the most suitable ARMS remains to be identified. This study aimed to evaluate the feasibility, safety, and efficacy of biliary drainage using duckbill\u2010shaped ARMS (D\u2010ARMS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter, retrospective observational study conducted at three Japanese tertiary institutions. Patients with distal malignant biliary obstruction who underwent biliary stenting using D\u2010ARMS were eligible to participate. Technical success, functional success, adverse event (AE), and time to RBO (TRBO) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty patients underwent biliary stenting using D\u2010ARMS from December 2018 to October 2019. The technical success rate and functional success rate were 93% and 87%, respectively. However, nonvisibility of the markers at the tip of the metal stent or spontaneous extension was occasionally observed, making biliary stenting using D\u2010ARMS difficult. Early AE occurred in 10% of the patients including cholangitis and pancreatitis. During the median postprocedural observation time of 5.1\u00a0months (range, 0.8\u201322.8), RBO occurred in 33% and the median TRBO was 261\u00a0days. As for reintervention, D\u2010ARMS could be extracted in 67% of the patients with RBO. However, the stent was torn off on removal in half of the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although some modifications are still needed, D\u2010ARMS was feasible and safe for biliary drainage, and sufficient TRBO was achieved. Subsequent multi\u2010institutional studies involving a larger number of patients and a longer follow\u2010up period are warranted to validate the present results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.13827","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T10:30:13Z","timestamp":1599042613000},"page":"648-655","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Feasibility of biliary stenting to distal malignant biliary obstruction using a novel designed metal stent with duckbill\u2010shaped anti\u2010reflux valve"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1349-8154","authenticated-orcid":false,"given":"Toshifumi","family":"Kin","sequence":"first","affiliation":[{"name":"Center for Gastroenterology Teine\u2010Keijinkai Hospital Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Okabe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Kurume University School of Medicine Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9433-8437","authenticated-orcid":false,"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3548-5215","authenticated-orcid":false,"given":"Akio","family":"Katanuma","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology Teine\u2010Keijinkai Hospital Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14955"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0659-9864"},{"key":"e_1_2_8_4_1","article-title":"A prospective multicenter study of partially covered metal stents in patients receiving neoadjuvant chemotherapy for resectable and borderline resectable pancreatic cancer: BTS\u2010NAC Study","author":"Saito K","journal-title":"Gut Liver."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-125062"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2005.05.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.12.054"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.08.048"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2012.01382.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2012.01324.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12112"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1364872"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000149"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.08.084"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl15579"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3805173"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13381"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12379"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.06.051"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12080"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-105643"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13614"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0878-8"},{"key":"e_1_2_8_25_1","article-title":"Antireflux metal stent for biliary obstruction: Any benefits?","volume":"33","author":"Hamada T","journal-title":"Dig Endosc"}],"container-title":["Digestive Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.13827","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/den.13827","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.13827","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T16:43:08Z","timestamp":1693154588000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/den.13827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,8]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/den.13827"],"URL":"https:\/\/doi.org\/10.1111\/den.13827","archive":["Portico"],"relation":{},"ISSN":["0915-5635","1443-1661"],"issn-type":[{"value":"0915-5635","type":"print"},{"value":"1443-1661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,8]]},"assertion":[{"value":"2020-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}