{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:44:42Z","timestamp":1788993882646,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Concomitant malignant gastric outlet obstruction (MGOO) and malignant biliary obstruction (MBO) represent a challenging clinical scenario in which the optimal endoscopic strategy remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to compare real-life combinations of endoscopic ultrasound-guided biliary drainage\u2014hepatogastrostomy (EUS-HGS) or choledochoduodenostomy (EUS-CDS)\u2014with gastric outlet obstruction management\u2014EUS-guided gastroenterostomy (EUS-GE) or enteral stenting (ES).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This was an international multicenter retrospective cohort study involving 11 tertiary centers (2017\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Consecutive patients with MBO and MGOO were included. All patients underwent both biliary and gastric outlet drainage using one of four combinations: EUS-HGS\/EUS-GE, EUS-HGS\/ES, EUS-CDS\/EUS-GE, or EUS-CDS\/ES. The primary outcome was stent dysfunction (biliary or digestive). Secondary outcomes included clinical success and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 159 patients were included (median age 70\u2009years; pancreatic cancer 64.8%). Stent dysfunction occurred in 12.0% of patients treated with EUS-HGS\/EUS-GE versus 26.6% with EUS-CDS\/ES, 36.7% with EUS-HGS\/ES, and 50.0% with EUS-CDS\/EUS-GE (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.059). At 12\u2009months, stent obstruction-free survival was significantly higher with EUS-HGS\/EUS-GE (84.0%) compared with EUS-CDS\/ES (51.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0466), EUS-CDS\/EUS-GE (42.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0377), and EUS-HGS\/ES (52.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0512). Severe adverse events were more frequent with EUS-HGS (15.0% in HGS\/ES; 8.0% in HGS\/EUS-GE) compared with EUS-CDS (1.6% in CDS\/ES; 0% in CDS\/EUS-GE;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In malignant obstruction, the choice of gastric outlet strategy appears to markedly influence biliary stent patency. When EUS-GE is performed, EUS-HGS may provide superior durability but at the cost of higher morbidity. Conversely, when ES is selected, EUS-CDS appears safer. These findings support a tailored approach integrating anatomical considerations and center expertise when selecting the optimal endoscopic double-drainage strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261446493","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:59:22Z","timestamp":1779454762000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Optimal endoscopic drainage strategy for concomitant biliary and gastric outlet obstruction: a multicenter retrospective study (ENDO-GOBO)"],"prefix":"10.1177","volume":"19","author":[{"given":"Thomas","family":"Beuchard","sequence":"first","affiliation":[{"name":"Service d\u2019H\u00e9pato-Gastro-Ent\u00e9rologie et Endoscopie Digestive, CHU Dupuytren, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Ratone","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie et Endoscopie Digestive, Institut Paoli-Calmette, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie et Endoscopie Digestive, CHRU Nancy\u2014H\u00f4pitaux de Brabois, Vandoeuvre-les-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Barthet","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9pato-Gastro-Ent\u00e9rologie et Endoscopie Digestive, APHM H\u00f4pital Nord, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Guilmoteau","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie et Endoscopie Digestive, CHU 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