{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:37Z","timestamp":1790690857508,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Endoscopic ultrasound\u2010guided gallbladder drainage is increasingly used for malignant distal biliary obstruction, yet predictors of drainage dysfunction remain unknown. This study aimed to identify clinical and procedural factors associated with dysfunction, clinical success, and morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, international, multicenter cohort study included consecutive patients who underwent endoscopic ultrasound\u2010guided gallbladder drainage with electrocautery\u2010enhanced lumen\u2010apposing metal stents for malignant distal biliary obstruction across 17 centers (March 2017\u2013September 2024). The primary endpoint was biliary drainage dysfunction analyzed using Kaplan\u2013Meier estimation and Cox regression. Secondary endpoints included predictors of clinical success and high\u2010grade adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 166 patients were included. Technical and clinical success rates were 98.8% (164\/166) and 82.9% (136\/164), respectively. Among 146 patients in the survival analysis, 12\u2010month biliary patency was 70.4%. Neither the access route (transgastric 68.5% vs. transduodenal 73.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.50) nor stent diameter (8, 10, or 15\u2009mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.82) influenced patency. Ascites was the only independent predictor of dysfunction (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      2.45 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.17\u20135.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Endoscopic ultrasound\u2010confirmed cystic duct patency was independently associated with clinical success (86.7% vs. 69.4%,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.88 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.19\u20136.96],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). The 15\u2010mm stent was associated with fewer high\u2010grade adverse events (14.3% vs. 32.9%,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.31 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.14\u20130.69],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) without affecting patency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large multicenter series, neither access route nor stent diameter influenced biliary patency. Ascites was the sole independent predictor of dysfunction. A protective signal of 15\u2009mm stents against high\u2010grade morbidity warrants prospective confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70211","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:35:23Z","timestamp":1784039723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictors of Biliary Drainage Dysfunction Following\n                    <scp>EUS<\/scp>\n                    \u2010Guided Gallbladder Drainage for Malignant Distal Biliary Obstruction: A Multicenter Retrospective Study"],"prefix":"10.1111","volume":"38","author":[{"given":"M.","family":"Goudot","sequence":"first","affiliation":[{"name":"Department of Gastroenterology University Hospital of Nimes, University of Montpellier  Nimes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9 Centre de Recherche Saint Antoine (CRSA) &amp; H\u00f4pital Saint Antoine, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Caillo","sequence":"additional","affiliation":[{"name":"CHU N\u00eemes  N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Privat","sequence":"additional","affiliation":[{"name":"Vichy Hospital  Vichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ouazana","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9 Centre de Recherche Saint Antoine (CRSA) &amp; H\u00f4pital Saint Antoine, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Leblanc","sequence":"additional","affiliation":[{"name":"H\u00f4pital Priv\u00e9 Jean Mermoz  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Napol\u00e9on","sequence":"additional","affiliation":[{"name":"H\u00f4pital Priv\u00e9 Jean Mermoz  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Jacques","sequence":"additional","affiliation":[{"name":"Limoges University Hospital  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Moryoussef","sequence":"additional","affiliation":[{"name":"Poissy\u2010Saint\u2010Germain Hospital  Poissy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. F.","family":"Bourgaux","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University Hospital of Nimes, University of Montpellier  Nimes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"G\u00e9rard","sequence":"additional","affiliation":[{"name":"CHU Lille Service des Maladies de l'Appareil Digestif  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Loras","family":"Alastruey","sequence":"additional","affiliation":[{"name":"Hospital Universitari M\u00fatua de Terrassa, Terrassa  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bazaga","sequence":"additional","affiliation":[{"name":"Hospital General de Granollers  Granollers Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Clinique Saint Jean Sud de France  Saint Jean de Vedas France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Albouys","sequence":"additional","affiliation":[{"name":"Limoges University Hospital  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7296-5464","authenticated-orcid":false,"given":"N.","family":"Williet","sequence":"additional","affiliation":[{"name":"Saint\u2010Etienne University Hospital  Saint\u2010Etienne 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