Evidence map›Paper›PMID 40991156›Full record

ArticleDigestive diseases and sciences2026

Endoscopic Choledochoduodenostomy Versus Gallbladder Drainage for Malignant Biliary Obstruction: A Propensity Score Matched Study.

Noppachai Siranart, Christopher C Thompson, Marvin Ryou, Steven N Steinway

Abstract readMulticenter StudyComparative Study
PubMed Publisher
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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

4 authors.

Noppachai SiranartDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Christopher C ThompsonDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Marvin RyouDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Steven N SteinwayDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. ssteinway@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEndoscopic ultrasound-guided gallbladder drainage (EUS-GB) is an emerging alternative to choledochoduodenostomy (EUS-CBD) for malignant distal biliary obstruction (MDBO), particularly when conventional access is not feasible.

methodsWe conducted a multicenter, retrospective study of patients undergoing EUS-GB or EUS-CBD for MDBO between January 2015 and October 2024. Primary outcomes were technical and clinical success. Secondary outcomes included procedural time, 6-month reintervention, adverse events (AEs), and all-cause mortality. Propensity score matching (PSM) was used to adjust for baseline differences.

resultsEighty-two patients were included (22 EUS-GB, 60 EUS-CBD). Technical success was comparable between groups (95.5% vs. 96.7%). EUS-GB was used as salvage in 50% of cases when EUS-CBD was not feasible, with a 90.9% technical success rate. PSM yielded 21 matched pairs. After propensity score matching, clinical success was similar (95.2% EUS-GB vs. 85.7% EUS-CBD, p = 0.61). EUS-GB had significantly lower 6-month reintervention (4.8% vs. 23.8%, p = 0.004) and stent-related complications (0% vs. 18.9%). Adverse event rates and all-cause mortality were similar. Median follow-up was 116 days (IQR: 51-300). In the EUS-GB group, pre-procedural cystic duct patency predicted clinical success (94.1%).

conclusionEUS-GB is a technically effective and clinically comparable alternative to EUS-CDS for MDBO, with significantly fewer reinterventions and stent-related complications. When cystic duct patency is confirmed on imaging, EUS-GB may be considered as a primary approach or salvage strategy for biliary drainage in MDBO.

Indexed as

CholedochostomyCholestasisDrainageGallbladderAgedAged, 80 and overEndosonographyFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeUltrasonography, InterventionalCholedochoduodenostomyDirect access biliary drainageEndoscopic ultrasoundEndoscopic ultrasound guided gallbladder drainageMalignant biliary obstruction

Identifiers

PMID40991156

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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.