← Issue №14/ week of Oct 4, 2026/Endoscopy

Endoscopic Ultrasound-Guided Hepaticogastrostomy With Plastic Stent Versus Metallic Stent for Malignant Biliary Obstruction: A Meta-Analysis.

From GI Signals issue №14: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy meta analysis · n=342 · Oct 1, 2026 · Dig Endosc · IF 5.2

Endoscopic Ultrasound-Guided Hepaticogastrostomy With Plastic Stent Versus Metallic Stent for Malignant Biliary Obstruction: A Meta-Analysis.

New evidenceEUSbiliary stricturemeta-analysisendoscopy quality
Clinical takeawayConsider using metal stents for EUS-HGS in malignant biliary obstruction after ERCP failure when prioritizing longer patency, but weigh the higher risk of adverse events compared to plastic stents.
What it foundIn EUS-HGS for malignant biliary obstruction after ERCP failure, metal stents had longer time to recurrent biliary obstruction (HR 1.83, 95% CI 1.42-2.36) but higher adverse event rates (OR 0.48, 95% CI 0.30-0.77) compared to plastic stents.
ContextRefines stent selection in EUS-HGS for malignant biliary obstruction after ERCP failure, confirming metal stents' longer patency but higher adverse event risk compared to plastic stents.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Yamazaki H … Kitano M · Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society · IF 5.2 · PubMed ↗Permalink
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