{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:33:58Z","timestamp":1791894838192,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Whether metal stents (MS) or plastic stents (PS) yield better outcomes for malignant biliary obstruction in endoscopic ultrasound\u2010guided hepaticogastrostomy (EUS\u2010HGS) is controversial. We aimed to compare outcomes of initial EUS\u2010HGS performed with MS or PS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<jats:bold>s<\/jats:bold><\/jats:title><jats:p>In this single\u2010center retrospective study, we included patients (MS\/PS groups: <jats:italic>n<\/jats:italic>\u2009=\u2009151\/72) with unresectable malignant biliary obstruction and performed multivariable analysis. The landmark date was defined as day 100 and used to evaluate the time to recurrent biliary obstruction (TRBO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The clinical success rate was similar in both groups. The mean total bilirubin percentage decrease at week 2 was significantly higher in the MS group than in the PS group (\u221245.1% vs. \u221223.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.016). Median TRBO was significantly different between the MS and PS groups (183 and 92\u2009days, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.017). TRBO within 100\u2009days was comparable in both groups but was significantly shorter only after 100\u2009days in the PS group (adjusted hazard ratio 12.8, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Adverse events were significantly more common in the MS group (23.8% vs. 9.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.012), although they occurred relatively frequently even with PS in the cholangitis subgroup (<jats:italic>P<\/jats:italic><jats:sub>interaction<\/jats:sub>\u2009=\u20090.034). After endoscopic re\u2010intervention, TRBO tended to be longer with revision PS (hazard ratio 0.40, <jats:italic>P<\/jats:italic>\u2009=\u20090.47).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although MS provided early improvement of jaundice and long stent patency, PS provided a better safety profile and comparable stent patency until 100\u2009days. PS might also be an adequate and optimal palliation method in EUS\u2010HGS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14956","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T08:51:26Z","timestamp":1731660686000},"page":"117-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Metal stent versus plastic stent in endoscopic ultrasound\u2010guided hepaticogastrostomy for unresectable malignant biliary obstruction: Large single\u2010center retrospective comparative study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6152-8920","authenticated-orcid":false,"given":"Daiki","family":"Yamashige","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital  Tokyo 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