{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:44:16Z","timestamp":1789533856142,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>It is unclear which is the best approach for the drainage of malignant distal biliary obstruction (MDBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). We compared endoscopic ultrasound (EUS)\u2010guided gallbladder drainage (GBD) and EUS\u2010guided choledocoduodenostomy (CDS) with lumen\u2010apposing metal stents (LAMS) as rescue treatment in the case of ERCP failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an international multicenter retrospective observational study at 28 tertiary\u2010care centers. Outcomes were compared using propensity score matching (PSM). Clinical success was the primary outcome, with technical success, adverse event (AE) rate, and overall survival being the secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five hundred twenty\u2010nine patients underwent EUS\u2010guided drainage, of which 136 underwent EUS\u2010GBD, and 393 underwent EUS\u2010CDS. After 1\u2010to\u20101 PSM, 112 patients per group were selected. EUS\u2010GBD and EUS\u2010CDS had similar technical success (97.3% and 91%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08) and clinical success rates (83% and 85.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17). AE rate was 19.6% in the EUS\u2010GBD group and 12.5% in the EUS\u2010CDS group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20), of which 10 (8.9%) and 7 (6.2%) were severe AEs respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.61). Bleeding occurred in seven patients (6.1%) after EUS\u2010GBD and three patients (2.5%) after EUS\u2010CDS, whereas five infectious events were registered after EUS\u2010GBD (4.4%) and four cases (3.5%) after EUS\u2010CDS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.29). No treatment\u2010related deaths were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with MDBO after failed ERCP, EUS\u2010GBD or EUS\u2010CDS were comparable with similar rates of efficacy and safety. EUS\u2010GBD could represent an easy and safe option in MDBO patients without previous cholecystectomy and with a clear patency of the cystic duct.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70145","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:36:46Z","timestamp":1775641006000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of\n                    <scp>ERCP<\/scp>\n                    Failure in Malignant Biliary Obstruction: Comparative Effectiveness and Safety of\n                    <scp>EUS<\/scp>\n                    \u2010Guided Gallbladder Drainage Versus Choledocoduodenostomy"],"prefix":"10.1111","volume":"38","author":[{"given":"Benedetto","family":"Mangiavillano","sequence":"first","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Humanitas Mater Domini  Castellanza Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3440-4981","authenticated-orcid":false,"given":"Gianluca","family":"Franchellucci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Rozzano Italy"},{"name":"IBD Unit, Department of Gastroenterology Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Auriemma","sequence":"additional","affiliation":[{"name":"Gastrointestinal Endoscopy Unit, Humanitas Mater Domini  Castellanza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl","family":"Ramai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Endoscopy Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Fugazza","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Barbera","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini  Teramo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-1761","authenticated-orcid":false,"given":"Giuseppe","family":"Vanella","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center IRCCS San Raffaele Institute and Vita\u2010Salute University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8758-654X","authenticated-orcid":false,"given":"Germana","family":"De Nucci","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense, Garbagnate Milanese  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fuller","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Mart\u00ednez\u2010Moreno","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Digestive Diseases Hospital General Universitario de Alicante, Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL)  Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Di Mitri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit ARNAS Civico\u2014Di Cristina\u2014Benfratelli Hospital  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Therapeutic GI Endoscopy Unit Campus Bio\u2010Medico University Hospital  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Robles","family":"Medranda","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Division Instituto Ecuatoriano de Enfermedades Digestivas, University Hospital Omni  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Anderloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Fondazione IRCCS Policlinico San Matteo  Pavia Italy"},{"name":"Department of Internal Medicine and Medical Therapeutics University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"De Luca","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology and Digestive Endoscopy ASST Santi Paolo e Carlo  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Yuen Bun","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Surgery, HK Sanatorium &amp; Hospital  Hong Kong City Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Vargas\u2010Madrigal","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Enrique Baltodano Briceno Hospital  Liberia Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Forti","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy, Ospedale Niguarda\u2010Ca' Granda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Bronswijk","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology KU Leuven University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santi","family":"Mangiafico","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Azienda Ospedaliero\u2014Universitaria Policlinico \u201cG. 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