Evidence map›Paper›PMID 40828340›Full record

ArticleDigestive diseases and sciences2026

Entero-Enteric Lumen Apposing Metal Stents (LAMS) for Biliary Access in Patients with Altered Anatomy.

Divya Chalikonda, Shuji Mitsuhashi, Brianna Shinn, Amy Tyberg, Haroon Shahid, Avik Sarkar, Michel Kahaleh, Harshit S Khara, Bradley Confer, Faisal Kamal and 5 more

Abstract readMulticenter Study
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In one paragraph

Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Divya ChalikondaDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
Shuji MitsuhashiDepartment of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Brianna ShinnDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
Amy TybergDivision of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ, USA.
Haroon ShahidDivision of Gastroenterology, Hackensack Meridian Health-Jersey Shore University Medical Center, Neptune, NJ, USA.
Avik SarkarDivision of Gastroenterology, Hackensack Meridian Health-Jersey Shore University Medical Center, Neptune, NJ, USA.
Michel KahalehDivision of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ, USA.
Harshit S KharaDivision of Gastroenterology, Geisinger Medical Center, Danville, PA, USA.
Bradley ConferDivision of Gastroenterology, Geisinger Medical Center, Danville, PA, USA.
Faisal KamalDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA. fkamal36@gmail.com.
Austin ChiangDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
Alexander SchlachtermanDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
Anand KumarDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
David LorenDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
Thomas KowalskiDivision of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsBiliary access in patients with Roux-en-Y hepaticojejunostomy, pancreaticoduodenectomy and duodenal switch can be challenging. Placement of an EUS guided lumen apposing metal stent (LAMS) between the small bowel and the afferent jejunal limb can create an entero-enteric conduit (EUS-EE), allowing for successful endoscopic access to the biliary tree for intervention. In this study, we aim to describe the safety and efficacy of EUS-EE for biliary access.

methodsThis is a multicenter retrospective cohort study of patients who underwent EUS-EE for the purpose of biliary intervention at three US centers. The primary outcome was technical success. Secondary outcomes included clinical success, defined as ability to perform intended biliary intervention and adverse events. Descriptive statistics were used to analyze the data.

resultsEighteen patients underwent EUS-EE for biliary access. The most common surgical anatomy was a Roux-en-Y hepaticojejunostomy (66.6%). 72.2% of patients had either deep enteroscopy or a hepaticogastrostomy attempted for biliary access prior to proceeding with EUS-EE placement. A 20 mm LAMS was used in 12 patients and 15 mm used in 6 patients. Technical and clinical success was achieved in 100% of patients. Two adverse events were noted; 1 patient had a perforation of the opposite jejunal wall that was treated with through-the-scope clips and one patient had minor bleeding that was managed conservatively.

conclusionThis study demonstrates the feasibility, safety, and efficacy of EUS-EE for management of biliary disorders in patients with surgically altered anatomy. Future large scale multicenter studies are needed to further validate these findings.

Indexed as

StentsAdultAgedAnastomosis, Roux-en-YEndosonographyFemaleHumansMaleMetalsMiddle AgedRetrospective StudiesTreatment OutcomeMetalsAltered surgical anatomyBiliary disordersEntero-enteric LAMS

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.