{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:55:55Z","timestamp":1781812555175,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"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":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Malignant biliary obstruction (MBO) often necessitates endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage. Although ERCP is the standard treatment, post\u2010procedural infections such as cholangitis and cholecystitis remain clinically important. Current guidelines recommend prophylactic antibiotics only for high\u2010risk cases. However, data focused specifically on patients with distal MBO (DMBO) undergoing stent placement are limited. This study evaluated the effect of peri\u2010ERCP antibiotics on post\u2010ERCP infectious adverse events in DMBO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included 508 patients who underwent initial biliary stent placement for DMBO between January 2020 and August 2024 at five institutions. Patients were categorized according to whether they received peri\u2010ERCP antibiotics. Propensity score matching (1:1) was performed using clinically relevant covariates. The primary outcome was the incidence of infectious adverse events (cholangitis or cholecystitis) within 5\u2009days of ERCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 165 patients were included in each group. The incidence of infectious adverse events was significantly lower in the peri\u2010ERCP antibiotic group (3.6%) compared with the nonantibiotic group (10.3%), with a risk difference (RD) of 6.7% (95% confidence interval [CI]: 1.2\u201312.1). Post\u2010ERCP pancreatitis occurred in 10 patients (6.1%) without prophylaxis and 16 (9.7%) with prophylaxis, showing no significant difference (RD: \u22123.6%, 95% CI: \u22129.4 to 2.2). Subgroup analysis suggested greater benefit in patients with nonpancreatic cancer (RD, 0.206; 95% CI, 0.07\u20130.342;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) or a bile duct diameter &gt;\u200910\u2009mm (RD, 0.104; 95% CI, 0.046\u20130.163;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Peri\u2010ERCP antibiotics may reduce post\u2010ERCP infectious adverse events in patients with DMBO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70211","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T05:40:50Z","timestamp":1767073250000},"page":"696-704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Peri\u2010Procedural Antibiotics on Post\u2010ERCP Infectious Adverse Events With Distal Malignant Biliary Obstruction"],"prefix":"10.1111","volume":"41","author":[{"given":"Tatsunori","family":"Satoh","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Shizuoka General Hospital  Shizuoka Japan"},{"name":"Research Support Center Shizuoka General Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shizuoka General Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Nakatani","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Graduate School of Medical Science Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Seirei Hamamatsu General Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-8655","authenticated-orcid":false,"given":"Fumitaka","family":"Niiya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6637-6997","authenticated-orcid":false,"given":"Junichi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Iwata City Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuma","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, School of Medicine Sapporo Medical University  Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Shizuoka General Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3796-3108","authenticated-orcid":false,"given":"Tetsushi","family":"Azami","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Noda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-7955","authenticated-orcid":false,"given":"Shinya","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shizuoka General Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14825"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002190"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0659-9864"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1075-4080"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.06.051"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002495"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01279.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.113381"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.139"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.15279\/kpba.2017.22.1.24"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v14.i10.581"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hbpd.2018.01.002"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00074"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2023.107347"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.968729"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.515"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.512"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609263351301"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.409"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2024.031"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1012830"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(92)70474-X"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(94)70247-0"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/20.5.1236"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.161"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2014.990504"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010025\u201009486\u2010x"},{"issue":"3","key":"e_1_2_12_29_1","first-page":"296","article-title":"Microbial Profile of Biliary Tract Infection in Patients Undergoing Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP), and Baseline Risk Factors Predicting Microbial Growth and Post\u2010ERCP Cholangitis","volume":"19","author":"Ismail H.","year":"2024","journal-title":"Przegla\u031cd Gastroenterologiczny"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S165016"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-023-02976-0"},{"issue":"138","key":"e_1_2_12_32_1","first-page":"417","article-title":"Evaluation of Antibiotic Use to Prevent Post\u2010Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Cholangitis","volume":"62","author":"Ishigaki T.","year":"2015","journal-title":"Hepato\u2010Gastroenterology"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.767"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.06.004"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.02.040"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-5263-5"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.129"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.09.021"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-28309-w"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.70211","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:09:34Z","timestamp":1781809774000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.70211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jgh.70211"],"URL":"https:\/\/doi.org\/10.1111\/jgh.70211","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]},"assertion":[{"value":"2025-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}