{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:55:46Z","timestamp":1792155346201,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"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":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) represents the gold standard for jaundice palliation in patients with distal malignant biliary obstruction (DMBO). Biliary drainage using electrocautery lumen apposing metal stent (EC\u2010LAMS) is currently a well\u2010established procedure when ERCP fails. In a palliative setting the endoscopic ultrasound\u2010guided gallbladder drainage (EUS\u2010GBD) could represent an easy and valid option. We performed a prospective study with a new EC\u2010LAMS with the primary aim to assess the clinical success rate of EUS\u2010GBD as a first\u2010line approach to the palliation of DMBO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In all, 37 consecutive patients undergoing EUS\u2010GBD with a new EC\u2010LAMS were prospectively enrolled. Clinical success was defined as bilirubin level decrease &gt;15% within 24\u2009h and\u2009&gt;50% within 14\u2009days after EC\u2010LAMS placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 73.5\u2009\u00b1\u200910.8\u2009years; there were 17 male patients (45.9%). EC\u2010LAMS placement was technically feasible in all patients (100%) and the clinical success rate was 100%. Four patients (10.8%) experienced adverse events, one bleeding, one food impaction, and two cystic duct obstructions because of disease progression. No stent\u2010related deaths were observed. The mean hospitalization was 7.7\u2009\u00b1\u20093.4\u2009days. Median overall survival was 4\u2009months (95% confidence interval 1\u20138).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic ultrasound\u2010guided gallbladder drainage with the new EC\u2010LAMS is a valid option in palliative endoscopic biliary drainage as a first\u2010step approach in low survival patients with malignant jaundice unfit for surgery. A smaller diameter EC\u2010LAMS should be preferred, particularly if the drainage is performed through the stomach, to avoid potential food impaction, which could result in stent dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14606","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T19:14:16Z","timestamp":1685474056000},"page":"351-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Endoscopic ultrasound\u2010guided gallbladder drainage as a first approach for jaundice palliation in unresectable malignant distal biliary obstruction: Prospective study"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-7448","authenticated-orcid":false,"given":"Benedetto","family":"Mangiavillano","sequence":"first","affiliation":[{"name":"Gastrointestinal Endoscopy Unit Humanitas Mater Domini  Varese Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Ho","family":"Moon","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine SoonChunHyang University School of Medicine  Bucheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical and Surgical Sciences University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Vargas\u2010Madrigal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy Hospital Enrique Baltodano Brice\u00f1o  Liberia Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Campus\u2010Bio Medico University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianenrico","family":"Rizzatti","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Fondazione Policlinico Universitario A. 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