United European Gastroenterology Journal最新文献

{"title":"An App-Based Proton Pump Inhibitor Discontinuation Tool: A Multicentre, Open-Label, Randomised Superiority Trial.","authors":"Lieke M Koggel, Thomas Timmers, Marten A Lantinga, Rudolf B Kool, Cornelis Kramers, Noortje van Herwaarden, Peter D Siersema","doi":"10.1002/ueg2.70297","DOIUrl":"10.1002/ueg2.70297","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are frequently used without long-term indication. Discontinuation remains challenging because of rebound symptoms. Whether digital guidance tools improve discontinuation is unknown. We evaluated whether an app improves PPI discontinuation.</p><p><strong>Methods: </strong>In this open-label adaptive randomised controlled superiority trial, adults using daily PPI for ≥ 4 weeks without chronic PPI indication, according to the Dutch College of General Practitioners guideline, were recruited from outpatient clinics of Internal Medicine, Gastroenterology, Rheumatology and Nephrology departments at three Dutch hospitals. Patients were excluded if their physician deemed PPI use necessary beyond guideline recommendations, after prior upper gastrointestinal surgery, in case of inability to understand the study, unavailability of a smartphone/tablet, or limited life expectancy. Patients were randomly assigned (1:1), stratified by department and initial indication, to receive information on PPI discontinuation through an app (intervention) or brochure (control). Primary outcome was PPI discontinuation at 2 months follow-up, defined as self-declared intake of ≤ 1 tablet in the preceding 14 days. Sample-size was revised earlier than prespecified based on interim data. The trial is registered as closed to accrual at ClinicalTrials.gov (NCT05348252).</p><p><strong>Results: </strong>Between May 15, 2022, and March 31, 2023, 174 patients were randomized (86 intervention, 88 control). Nine and two patients, respectively, did not receive the allocated intervention. Of the 163 participants (mean age 54 y/o [SD 11], 76 males [47%]), 66/77 (86%) discontinued PPIs in the intervention group versus 55/86 (64%) in the control group (RR 1.34, 95% CI 1.11-1.61, p = 0.002). Adverse events occurred in 18/121 (15%) patients who discontinued PPI use and in 6/42 (14%) who did not. Only 4/121 (3%) and 1/42 (2%), respectively, were potentially attributable to PPI discontinuation.</p><p><strong>Conclusion: </strong>An app-based intervention significantly improves discontinuation of inappropriate PPI use compared with an information brochure and could therefore be considered for PPI deprescribing initiatives.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 8","pages":"e70297"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Discovering Hereditary Risk Through Surveillance: A Prospective Genetic Analysis of Individuals With Familial Pancreatic Cancer\".","authors":"","doi":"10.1002/ueg2.70288","DOIUrl":"10.1002/ueg2.70288","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70288"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Psychosocial Characteristics of Adult Primary Care IBS Patients: A Post hoc Analysis of the DOMINO Study.","authors":"Robbe Wils, Bert Broeders, Karen Van den Houte, Jan Tack, Florencia Carbone","doi":"10.1002/ueg2.70276","DOIUrl":"10.1002/ueg2.70276","url":null,"abstract":"<p><strong>Background: </strong>The majority of irritable bowel syndrome (IBS) patients are diagnosed and managed in primary care, but this setting is underinvestigated to date.</p><p><strong>Objective: </strong>The present study aimed to improve our understanding of IBS in primary care by evaluating the clinical and psychosocial characteristics of affected patients.</p><p><strong>Methods: </strong>We performed a cross-sectional post hoc analysis of the DOMINO study, which enrolled 483 adult IBS patients newly diagnosed by primary care physicians. We investigated baseline demographics and questionnaires assessing Rome IV criteria and stool pattern subtype, symptom severity (IBS-SSS), quality of life (IBS-QoL), somatic symptom disorder (PHQ-12), depression (PHQ-9) and anxiety (GAD-7).</p><p><strong>Results: </strong>70% of the primary care diagnosed IBS patients fulfilled the Rome IV criteria (Rome+). The stool pattern subtype distribution according to the Rome IV diagnostic questionnaire was: 20% constipation (IBS-C), 33% diarrhea (IBS-D), 31% mixed (IBS-M) and 16% unclassified (IBS-U). Mean IBS-SSS was 268 ± 98, with 46% and 36% of cases reporting moderate and severe IBS-SSS, respectively. Rome + patients had, compared to Rome-, a significantly higher IBS-SSS, lower quality of life and higher psychosocial comorbidity. IBS-M, IBS-D and IBS-C participants scored significantly higher on IBS-SSS and IBS-QoL than IBS-U. Furthermore, IBS-M had significantly higher somatic symptom disorder and depression and anxiety levels compared with IBS-U.</p><p><strong>Conclusion: </strong>The majority of primary care IBS patients fulfilled the Rome IV criteria, were subtyped as IBS-D or IBS-M and were characterised by moderate or severe IBS-SSS. Rome+ and IBS-M participants had higher symptom severity, lower quality of life and higher psychosocial comorbidity.</p><p><strong>Clinicaltrials: </strong>gov, Number NCT04270487.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70276"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Bowel Urgency and Intestinal Ultrasound Parameters in Ulcerative Colitis: Insights Into Transmural Inflammation and Symptom Pathophysiology.","authors":"Kanade Serizawa, Shintaro Sagami, Satoko Umeda, Kunio Asonuma, Moeko Komatsu, Shunsuke Shibui, Masa Maeda, Akira Nogami, Ryo Karashima, Masaru Nakano, Ichiro Maeda, Toshifumi Hibi, Chika Kusano, Taku Kobayashi","doi":"10.1002/ueg2.70293","DOIUrl":"10.1002/ueg2.70293","url":null,"abstract":"<p><strong>Background: </strong>Bowel urgency (BU) is a key symptom of ulcerative colitis (UC), often impairing the quality of life. This study aimed to identify intestinal ultrasound parameters associated with BU, given that UC may also have transmural involvement, and compare these with endoscopic activity and biomarkers.</p><p><strong>Methods: </strong>In this single-centre prospective study, UC patients undergoing colonoscopy between January 31 and September 27, 2023 were enrolled. Transabdominal and transperineal ultrasound were performed to evaluate bowel wall thickness (BWT), including individual layers (mucosa, submucosa, and muscularis propria), and colour Doppler signal (CDS) in the sigmoid colon and rectum. BU was defined according to the Simple Clinical Colitis Activity Index urgency subscore.</p><p><strong>Results: </strong>Of 59 patients, 33 (56%) reported BU. Compared with those without BU, patients with BU had significantly higher C-reactive protein, Mayo Endoscopic Subscore (MES), BWT (descending colon, sigmoid colon, rectum), CDS (sigmoid colon, rectum), and submucosal and muscularis propria thickness in the sigmoid colon (all p < 0.05). Mucosal thickness and faecal calprotectin were not significantly different (p = 0.11 and p = 0.48, respectively). In MES-adjusted logistic regression, submucosal (p < 0.01) and muscularis propria (p = 0.03) thickness remained associated with BU, whereas mucosal thickness did not (p = 0.97). Receiver operating characteristic analysis showed that sigmoid submucosal thickness had greater diagnostic accuracy than mucosal thickness (AUC 0.77 vs. 0.62, p < 0.05).</p><p><strong>Conclusions: </strong>Sigmoid submucosal thickening was associated with BU and suggests that transmural inflammation may contribute to symptom pathophysiology.</p><p><strong>Trial registration: </strong>UMIN000050099.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70293"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiplex PCR to Diagnose Gastrointestinal Infections: Key Limitations in Interpretation.","authors":"Giannoula S Tansarli, Ferric C Fang","doi":"10.1002/ueg2.70272","DOIUrl":"10.1002/ueg2.70272","url":null,"abstract":"<p><p>Multiplex polymerase chain reaction (PCR) panels are increasingly used for the evaluation of acute diarrhea, providing rapid and sensitive detection of a broad range of enteric pathogens. However, their widespread adoption has created important interpretive challenges for clinicians. Positive results may reflect colonization, prolonged shedding, or organisms of uncertain pathogenicity rather than active infection, and current panels do not provide antimicrobial susceptibility or quantitative information. Incomplete pathogen coverage and false-positive detections may further complicate result interpretation, particularly in patients with mild or self-limited disease. Inappropriate test ordering or overinterpretation of results may lead to unnecessary antimicrobial therapy, delayed evaluation of non-infectious causes of diarrhea, and increased healthcare utilization. This review summarizes the key limitations of multiplex GI PCR panels and provides a practical framework for integrating molecular results with clinical presentation, disease severity, and patient risk factors to support informed management decisions in everyday clinical practice.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70272"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-Guided Choledochoduodenostomy Versus Hepaticogastrostomy in Case of Concomitant Gastric Outlet Obstruction Treated by EUS-Guided Gastroenterostomy: A Systematic Review and Meta-Analysis.","authors":"Marco Spadaccini, Yen-I Chen, Roberto Leone, Antonella Durante, Maria Margherita Massaro, Giuseppe Vanella, Maria Terrin, Matteo Colombo, Carlo Fabbri, Shannon Melissa Chan, Alessandro Fugazza, Roberto De Sire, Jeremie Albouys, Silvia Carrara, Jeremie Jacques, Daryl Ramai, Andrea Anderloni, Cesare Hassan, Paolo Giorgio Arcidiacono, Anthony Yuen Bun Teoh, Alessandro Repici","doi":"10.1002/ueg2.70265","DOIUrl":"10.1002/ueg2.70265","url":null,"abstract":"<p><strong>Background: </strong>Biliary (BO) and gastric outlet obstruction (GOO) frequently complicate pancreatic cancer, often delaying treatment. While EUS-guided gastroenterostomy (EUS-GE) is preferred over duodenal stenting for GOO, the optimal approach for biliary drainage (BD) between EUS-guided choledochoduodenostomy (EUS-CDS) and hepaticogastrostomy (EUS-HGS) remains undefined. This systematic review and meta-analysis aimed to identify the preferred BD strategy in patients undergoing EUS-GE for concurrent GOO and BO.</p><p><strong>Methods: </strong>We searched Medline, Scopus, and EMBASE up to February 2026. Studies were eligible if they reported outcomes of EUS-CDS or EUS-HGS in patients with malignant BO and concomitant GOO treated by EUS-GE. Outcomes included technical and clinical success, stent dysfunction, and adverse events (AEs) analyzed using a random-effects model. Results were reported as relative risks (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Five studies were included (128 patients; 45.5% female; mean age range 63.0-73.0 years), with 61 undergoing EUS-CDS and 67 undergoing EUS-HGS. Four studies were European, one American, and one prospective. Technical and clinical success rates were similar between groups (RR 0.96, 95% CI 0.83-1.11; I² = 0%; EUS-CDS 94.5% vs. EUS-HGS 96.4%), (RR 1.04, 95% CI 0.92-1.19; I² = 0%; EUS-CDS 96.5% vs. EUS-HGS 89.1%). Stent dysfunction was significantly higher in EUS-CDS (RR 4.42, 95% CI 1.71-11.43; I² = 0%; EUS-CDS 45.1% vs. EUS-HGS 10.9%), while AEs were comparable (RR 1.14, 95% CI 0.24-5.50; I² = 40.8%; EUS-CDS 10.7% vs. EUS-HGS 16.0%).</p><p><strong>Conclusions: </strong>EUS-CDS and EUS-HGS appear similarly safe and effective for managing malignant BO with concomitant GOO. However, EUS-CDS carries a significantly higher risk of stent dysfunction, potentially delaying critical cancer treatment.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70265"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting Globus Into Context: Prevalence, Characteristics, and Overlap With Other Disorders of Gut-Brain Interaction.","authors":"Karlien Raymenants, Cedric Van de Bruaene, Sawangpong Jandee, Marthe Everaert, Ami D Sperber, Olafur Palsson, Shrikant I Bangdiwala, Rutaba Khatun, Nathalie Rommel, Tim Vanuytsel, Jan Tack","doi":"10.1002/ueg2.70277","DOIUrl":"10.1002/ueg2.70277","url":null,"abstract":"<p><strong>Objective: </strong>Globus is characterized by the sensation of a lump in the throat without dysphagia or underlying structural abnormality or major motility disorder. Reported prevalences vary considerably across studies. Globus has been linked to both heartburn and affective disorders. This study aims to determine the global prevalence of globus, its association with heartburn, overlap with disorders of gut-brain interaction (DGBI) and psychosocial disorders, and its impact on health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>Internet surveys from the Rome Foundation Global Epidemiology study were used (N = 54,127). Rome IV criteria were used to identify globus and concurrent DGBI. Heartburn was defined as symptoms ≥ 2-3 days/week. Psychosocial co-morbidity and somatic symptom severity were assessed with PHQ-4 and PHQ-15, and HRQOL by PROMIS-10.</p><p><strong>Results: </strong>The global prevalence of globus according to Rome IV criteria was 0.75%, representing 12.8% of esophageal DGBI and 1.86% of all DGBI. Prevalence was highest in Western Europe (0.94%) and Asia (0.90%), and lowest in the Middle East (0.31%). Globus was slightly more common in females (55.4%), and most affected individuals were aged between 40 and 64 years (46.6%). Coexisting heartburn was reported in 17.4% of cases, esophageal DGBI in 9.1%, and non-esophageal DGBI in 49.0%. Anxiety and/or depression was present in 60.5%.</p><p><strong>Conclusion: </strong>Global prevalence of globus is 0.75%, with a slight female predominance, and is most prevalent below 65 years. Overlap with non-esophageal DGBI was greater than with heartburn symptoms or esophageal DGBI, and most patients had anxiety and/or depressive symptoms.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70277"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-Guided Choledochoduodenostomy With Lumen-Apposing Metal Stents: A Recommendation From an Expert Delphi Consensus.","authors":"Tawfik Khoury, Wisam Sbeit, Pietro Fusaroli, Khanh Do-Cong Pham, Michiel Bronswijk, Benedetto Mangiavillano, Sarah Leblanc, Sundeep Lakhtakia, Jeremie Jacques, Carlos Robles-Medranda, Anthony Yuen Bun Teoh, Giuseppe Vanella, Rares Ilie Orzan, Marco Spadaccini, Ilaria Tarantino, Andrea Anderloni, Cesare Hassan, Peter Siersema, Michel Kahaleh, Carlo Fabbri, Cecilia Binda, M Perez-Miranda, R L J van Wanrooij, Fabien Fumex, Rodica Gincul, Antonio Facciorusso, Schalk Van der Merwe, Paolo Giorgio Arcidiacono, Rastislav Kunda, Stefano Francesco Crinò, Pierre H Deprez, Andrea Lisotti, Bertrand Napoléon","doi":"10.1002/ueg2.70267","DOIUrl":"10.1002/ueg2.70267","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound-guided choledochoduodenostomy with a lumen apposing metal stent (EUS-CDS-L) is an increasingly utilized therapeutic option for biliary drainage. However, numerous procedural and periprocedural factors may influence technical and clinical outcomes. The aim of this study was to develop an expert consensus on key recommendations for EUS-CDS-L.</p><p><strong>Methods: </strong>Thirty-two international experts in EUS-CDS-L contributed to this Delphi process over two rounds by voting anonymously on 28 statements using a five-point Likert scale. Statements were accepted in the first round or revised in the second round based on an agreement level of ≥ 80%, with a median ≥ 4, and an interquartile range (IQR) ≤ 1.</p><p><strong>Results: </strong>28 statements were initially circulated, 2 were removed, and 26 were considered for final consensus. A consensus was achieved for 24 of 26 (92.3%) statements after two voting rounds across the three domains, with the first focusing on indications: (1) the preference for EUS-CDS-L in distal malignant biliary obstruction (DMBO) without gastric outlet obstruction (GOO); (2) the inclusion of EUS-CDS-L as a therapeutic option in benign biliary obstruction, and (3) the performance of EUS-CDS-L in patients scheduled for upfront surgery. A second domain focused on procedural considerations: (1) the preferred cutoff of common bile duct (CBD) diameter for safe EUS-CDS-L, and (2) the lack of evidence for antibiotic prophylaxis, and several technical steps in the recommended deployment process.</p><p><strong>Conclusion: </strong>This modified Delphi consensus provides international expert panel agreement on several key aspects of EUS-CDS-L, while also highlighting areas that require further research.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70267"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Acetate- Versus Lactate-Buffered Crystalloids for Prevention of Post-ERCP Pancreatitis in Patients Without Access to Rectal NSAIDs: A Multicentre Double-Blind Randomized Trial\".","authors":"","doi":"10.1002/ueg2.70294","DOIUrl":"10.1002/ueg2.70294","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70294"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-Guided Gallbladder Drainage for Acute Cholecystitis in the Western World: Heterogeneity in Current Practice and the Relation With Patient Outcome.","authors":"Louis De Wispelaere, Eva Hufkens, Hannah van Malenstein, Wim Laleman, Michiel Bronswijk, Schalk van der Merwe, Roberto Di Mitri, Michele Amata, Daniela Scimeca, Niels G Venneman, Koen R Beukema, Alberto Larghi, Antonio Pelegrino, Felice Molinario, Dominiek De Wulf, Elise Devolder, Dennis Yang, Mustafa Arain, Natalie Cosgrove, Muhammad K Hasan, Maham Hayat, Kambiz Kadkhodayan, Christophe Snauwaert, Roberto Trasolini, Cynthuja Thilakanathan, Shirley Jiang, Douglas G Adler, Lionel S D'Souza, Rogier P Voermans, Anouk G Overdevest, Roy L J Van Wanrooij, Enrique Pérez-Cuadrado-Robles, Willem J Lammers, Pieter Jan de Jonge, Marco J Bruno, Helena Degroote, Thomas Billiet, Alexander Arlt, Sebastian Stefanovic, Emine Gökce, Ellen Deschepper, Pieter Hindryckx","doi":"10.1002/ueg2.70275","DOIUrl":"10.1002/ueg2.70275","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis (AC), but some patients are unfit for (immediate) surgery. Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using a lumen-apposing metal stent (LAMS) is increasingly used in this population.</p><p><strong>Objective: </strong>This multicenter cohort study aimed to evaluate practice patterns in EUS-GBD across Western centers and to identify factors that influence outcomes.</p><p><strong>Design: </strong>We retrospectively analyzed data from patients undergoing EUS-GBD for AC across 18 centers. Patient-related, procedural and outcome data were collected. The primary outcomes of interest were LAMS-related adverse events (AEs), recurrent biliary disease, recurrent acute cholecystitis, and all-cause mortality. Time-to-event analyses were performed using center-stratified Cox proportional hazards and Fine-Gray competing-risk models to identify LAMS procedural factors associated with clinical outcomes.</p><p><strong>Results: </strong>We included 496 patients with a median follow-up of 176 days (IQR 44-569). Technical and clinical success rates of EUS-GBD were 98.2% and 93.5%, respectively. LAMS-related AEs and recurrent biliary disease occurred in 11.1% and 18.8% of patients, respectively. Transduodenal access was associated with a lower cumulative incidence of LAMS-related AEs compared with transgastric access (SHR 0.42, 95% CI 0.23-0.76, p = 0.004) and lower rates of recurrent biliary disease and recurrent acute cholecystitis during follow-up. Larger LAMS diameters (> 10 mm) were associated with a lower risk of recurrent acute cholecystitis and all-cause mortality. No association between coaxial DPPS placement and improved long-term outcomes could be demonstrated after competing-risk adjustment. Among patients undergoing interval cholecystectomy (N = 46), LAMS-related conversion from laparoscopy to laparotomy occurred in 3 cases (6.5%).</p><p><strong>Conclusions: </strong>In this large cohort study, transduodenal access route and choice of a large (> 10 mm) LAMS diameter were associated with improved outcomes of EUS-GBD. EUS-GBD may be a feasible option as a bridge to laparoscopic cholecystectomy, with limited risk of conversion to laparotomy. The findings of our study require prospective validation.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70275"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}