{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:02:02Z","timestamp":1790672522801,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Endoscopic ultrasound\u2010guided hepaticogastrostomy (EUS\u2010HGS) is an alternative procedure for malignant biliary obstruction after failure of endoscopic retrograde cholangiopancreatography. When performing EUS\u2010HGS, either plastic or metal stents are used, but selection often depends on the discretion of the endoscopist. We compared the efficacy and safety of plastic and metal stents during EUS\u2010HGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic meta\u2010analysis of all relevant articles listed by searching PubMed, Medline, and Web of Science databases. Random\u2010effects or fixed\u2010effects models were used to compare time to recurrent biliary obstruction (TRBO), clinical success rate, adverse event rate, rate of recurrent biliary obstruction, and re\u2010intervention success rate after EUS\u2010HGS with plastic and metal stents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This meta\u2010analysis included six eligible studies. The TRBO of the metal stent group was significantly longer than that of the plastic stent group (hazard ratio 1.83; 95% confidence interval [CI] 1.42\u20132.36). The total procedure\u2010related adverse event rate of the metal stent group was significantly higher than that of the plastic stent group (odds ratio [OR] 0.48; 95% CI 0.30\u20130.77). The recurrent biliary obstruction rate of the plastic stent group was significantly higher than that of the metal stent group (OR 1.75; 95% CI 1.06\u20132.88). No significant difference was found for the clinical success rate or re\u2010intervention success rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this meta\u2010analysis, metal stents showed longer TRBO, lower recurrent biliary obstruction rate, and higher adverse event rate than plastic stents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70289","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:18:59Z","timestamp":1790669939000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Ultrasound\u2010Guided Hepaticogastrostomy With Plastic Stent Versus Metallic Stent for Malignant Biliary Obstruction: A Meta\u2010Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5154-5014","authenticated-orcid":false,"given":"Hirofumi","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0343-7246","authenticated-orcid":false,"given":"Masahiro","family":"Itonaga","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1563-7181","authenticated-orcid":false,"given":"Ke","family":"Wan","sequence":"additional","affiliation":[{"name":"Clinical Study Support Center Wakayama Medical University Hospital  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6725-5708","authenticated-orcid":false,"given":"Yasunobu","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6918-3066","authenticated-orcid":false,"given":"Reiko","family":"Ashida","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6885-9223","authenticated-orcid":false,"given":"Masayuki","family":"Kitano","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.07.047"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2023.294"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14428"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.274"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.70194"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.631"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u2010109083"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14956"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2022.2118557"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.02.041"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010022\u201009346\u2010z"},{"key":"e_1_2_11_13_1","first-page":"719","article-title":"Statistical Aspects of the Analysis of Data From Retrospective Studies of Disease","volume":"22","author":"Mantel N.","year":"1959","journal-title":"Journal of the National Cancer Institute"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.2307\/2533446","article-title":"Operating Characteristics of a Rank Correlation Test for Publication Bias","volume":"50","author":"Begg C. 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