{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:35:17Z","timestamp":1790778917073,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Long\u2010term outcomes of endoscopic ultrasound\u2010guided choledochoduodenostomy (EUS\u2010CDS) performed with lumen apposing metal stents (LAMS) have been poorly evaluated in small or retrospective series, leading to an underestimation of LAMS dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive EUS\u2010CDS performed in three academic referral centers were included in prospectively maintained databases. Technical\/clinical success, adverse events (AEs), and dysfunction during follow\u2010up were retrospectively analyzed. Kaplan\u2013Meier analysis was used to estimate dysfunction\u2010free survival (DFS), with Cox proportional hazard regression to evaluate independent predictors of dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010three patients were included (male 56%; mean age, 70 years [95% confidence interval (CI) 68\u201372]; pancreatic cancer 81%, metastatic disease 47%). In 67% of procedures, 6\u2009mm LAMS were used. Technical and clinical success were achieved in 97.8% and 93.4% of patients, respectively, with AEs occurring in 9.7% (78% mild\/moderate). Dysfunction occurred in 31.8% of patients after a mean of 166 days (95% CI 91\u2013241), with an estimated 6\u2009month and 12\u2009month DFS of 75% and 52%, respectively; mean DFS of 394 (95% CI 307\u2013482) days. Almost all dysfunctions (96%) were successfully managed by endoscopic reintervention. Duodenal invasion (hazard ratio\u20092.7 [95% CI 1.1\u20136.8]) was the only independent predictor of dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic ultrasound\u2010guided choledochoduodenostomy shows excellent initial efficacy and safety, although stent dysfunctions occurs frequently during long\u2010term follow\u2010up. Almost all stent dysfunctions can be managed successfully by endoscopic reinterventions. We propose a comprehensive classification of the different types of dysfunction that may be encountered and rescue procedures that may be employed under these circumstances. Duodenal invasion seems to increase the risk of developing EUS\u2010CDS dysfunction, potentially representing a relative contraindication for this technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.14445","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T02:45:09Z","timestamp":1664505909000},"page":"377-388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Classification, risk factors, and management of lumen apposing metal stent dysfunction during follow\u2010up of endoscopic ultrasound\u2010guided choledochoduodenostomy: Multicenter evaluation from the Leuven\u2010Amsterdam\u2010Milan Study Group"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-1761","authenticated-orcid":false,"given":"Giuseppe","family":"Vanella","sequence":"first","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre IRCCS San Raffaele Scientific Institute and University  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":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg University of Leuven  Leuven Belgium"},{"name":"Department of Gastroenterology and Hepatology Imelda General Hospital  Bonheiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Dell'Anna","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre IRCCS San Raffaele Scientific Institute and University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogier P.","family":"Voermans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Laleman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Petrone","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre IRCCS San Raffaele Scientific Institute and University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"van Malenstein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam The Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers Vrije Universiteit, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Giorgio","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre IRCCS San Raffaele Scientific Institute and University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schalk","family":"van der Merwe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy L. J.","family":"van Wanrooij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers Vrije Universiteit, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0659-9864"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.11.022"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-13-147"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1309345"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1324-7919"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1738-6780"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.12.023"},{"key":"e_1_2_8_9_1","first-page":"185","article-title":"Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) guideline","volume":"54","author":"Merwe SW","year":"2021","journal-title":"Endoscopy"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1313-6850"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.08.017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.08.047"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1236-3217"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-08179-y"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08808-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05688-2"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.12.032"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08435-9"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.01.055"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-4845-6"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.09.040"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06106-1"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-2020-4"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13620"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1032-8218"},{"key":"e_1_2_8_27_1","first-page":"74","article-title":"Endoscopic sump syndrome secondary to EUS\u2010guided choledocho\u2010duodenostomy with a lumen\u2010apposing metal stent","volume":"111","author":"Mosquera\u2010Klinger G","year":"2019","journal-title":"Rev Esp Enferm Dig"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14252"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.14309\/crj.2018.14"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.02.027"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1782-7568"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001730"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.132"},{"key":"e_1_2_8_34_1","first-page":"163","article-title":"Comparison of the clinical impact of endoscopic ultrasound\u2010guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction","volume":"48","author":"Ogura T","year":"2016","journal-title":"Endoscopy"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.305"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.06.032"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13926"}],"container-title":["Digestive Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.14445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/den.14445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.14445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T12:57:25Z","timestamp":1692622645000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/den.14445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/den.14445"],"URL":"https:\/\/doi.org\/10.1111\/den.14445","archive":["Portico"],"relation":{},"ISSN":["0915-5635","1443-1661"],"issn-type":[{"value":"0915-5635","type":"print"},{"value":"1443-1661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,9]]},"assertion":[{"value":"2022-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}