{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:14:53Z","timestamp":1790079293829,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Recurrent biliary obstruction (RBO) is common after uncovered self\u2010expandable metal stent (UCSEMS) placement in unresectable distal malignant biliary obstruction. We compared stent patency, clinical outcomes, and RBO patterns between fully covered (FCSEMSs) and uncovered SEMSs (UCSEMSs) used as secondary stents after initial UCSEMS failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included 96 patients who underwent secondary SEMS placement for RBO (51 FCSEMSs, 45 UCSEMSs). Inverse probability of treatment weighting was applied. The primary outcome was stent patency; secondary outcomes included clinical success, adverse events (AEs), causes of RBO, and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjustment, median stent patency was comparable between FCSEMSs and UCSEMSs (145 vs. 188\u2009days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.435). Clinical success (92.2% vs. 98.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.146) and AE rates (12.2% vs. 6.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.323) were also similar. Tumor ingrowth was more common in the UCSEMS group, whereas sludge or food impaction was the predominant cause of RBO in the FCSEMS group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FCSEMSs and UCSEMSs showed comparable clinical outcomes as secondary stents after initial UCSEMS failure. While overall outcomes were similar, RBO patterns differed by stent type, with tumor ingrowth more frequent in UCSEMSs and sludge impaction or tumor overgrowth in FCSEMSs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70756","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:46:32Z","timestamp":1790077592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Uncovered and Covered Biliary SEMS for the Salvage of Obstructed SEMS: A Multicenter Retrospective Propensity Score\u2013Weighted Study"],"prefix":"10.1111","author":[{"given":"Ho Seung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Korea University Anam Hospital  Seoul Republic of Korea"},{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4502-7568","authenticated-orcid":false,"given":"Gunn","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8664-4090","authenticated-orcid":false,"given":"Sung Hyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongwook","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Jun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoonsub","family":"So","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ulsan University Hospital University of Ulsan College of Medicine  Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong\u2010Sik","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Wan","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"},{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/den.12078","article-title":"Biliary Self\u2010Expandable Metallic Stent for Unresectable Malignant Distal Biliary Obstruction: Which Is Better: Covered or Uncovered?","volume":"25","author":"Isayama H.","year":"2013","journal-title":"Digestive Endoscopy"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.gie.2018.03.029","article-title":"Covered Versus Uncovered Self\u2010Expandable Metal Stent for Palliation of Primary Malignant Extrahepatic Biliary Strictures: A Randomized Multicenter Study","volume":"88","author":"Conio M.","year":"2018","journal-title":"Gastrointestinal Endoscopy"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.gie.2019.06.032","article-title":"Covered and Uncovered Biliary Metal Stents Provide Similar Relief of Biliary Obstruction During Neoadjuvant Therapy in Pancreatic Cancer: A Randomized Trial","volume":"90","author":"Seo D. 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