ArticleAnnals of gastroenterology
Unilateral versus bilateral hilar stents for the treatment of cholangiocarcinoma: a multicenter international study.
Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Safety and Efficacy of Unilateral and Bilateral Stenting for Hilar Biliary Obstruction: An Updated Systematic Review and Meta-Analysis.Digestive diseases and sciences · 2026Pooled it
- Endoscopic treatment of malignant hilar biliary obstruction: A retrospective cohort study.World journal of gastrointestinal endoscopy · 2025Article
- Endoscopic treatment of unresectable perihilar cholangiocarcinoma: beyond biliary drainage.Therapeutic advances in gastroenterology · 2025Review
- Retrospective comparative study of new slim-delivery and conventional large-cell stents for stent-in-stent methods for hilar malignant biliary obstruction.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2024Article
- Review
- Optimal endoscopic drainage strategy for unresectable malignant hilar biliary obstruction.Clinical endoscopy · 2023Review
- Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review.Frontiers in oncology · 2023Review
- Endoscopic palliation of malignant biliary obstruction.World journal of gastrointestinal endoscopy · 2022Review
- FXR expression in rats of hilar cholangiocarcinoma.Scientific reports · 2022Article
- A single-center retrospective study comparing safety and efficacy of endoscopic biliary stenting only vs. EBS plus nasobiliary drain for obstructive jaundice.Frontiers in medicine · 2022Article
- Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma: When and how?World journal of gastrointestinal oncology · 2021Review
- Fully covered metal biliary stents: A review of the literature.World journal of gastroenterology · 2021Review
- Endoscopic metal stenting for malignant hilar biliary obstruction: an update meta-analysis of unilateral versus bilateral stenting.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021Article
- Diagnosis of hilar cholangiocarcinoma using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging.Abdominal radiology (New York) · 2021Article
- Bsep expression in hilar cholangiocarcinoma of rat model.Scientific reports · 2021Article
- Unilateral versus Bilateral Endoscopic Nasobiliary Drainage and Subsequent Metal Stent Placement for Unresectable Malignant Hilar Obstruction: A Multicenter Randomized Controlled Trial.Journal of clinical medicine · 2021Article
- Stent insertion for hilar cholangiocarcinoma: a meta-analysis of comparison between unilateral and bilateral stenting.Przeglad gastroenterologiczny · 2021Review
- NTCP Change in Rats of Hilar Cholangiocarcinoma and Therapeutic Significance.Technology in cancer research & treatmentArticle
Corrections and comments
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Authors and funding
19 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundEndoscopic placement of hilar stents is an accepted palliative therapy for patients with advanced, unresectable cholangiocarcinoma. However, whether unilateral versus bilateral stent placement provides optimal relief continues to be a subject of debate. The aim of this study was to compare the technical and clinical outcomes in patients with inoperable cholangiocarcinoma who received unilateral or bilateral self-expanding metal stents (SEMS).
methodsWe conducted a multicenter, international retrospective study of 187 patients with cholangiocarcinoma who received unilateral or bilateral SEMS. Outcomes included, but were not limited to, technical success, clinical success, adverse events, stent occlusion, and survival time. Results were further stratified based on the Bismuth classification.
resultsFifty patients received unilateral stents and 137 patients received bilateral stents. All patients achieved technical success. The clinical success rates were 86% for unilateral stents and 82.5% for bilateral stents (P>0.99). Clinical success was not statistically different for either group when stratified by the Bismuth classification (P=0.62 and P=0.72 respectively). There were significantly more adverse events in the bilateral stents group (11.7% vs. 0%, P=0.007). There was no greater risk of stent occlusion when bilateral stents were used (unadjusted P=0.71, adjusted P=0.81). There was a greater risk of death for patients who received bilateral SEMS (hazard ratio 1.78, 95% confidence interval 1.09-2.89; P=0.02).
conclusionsUnilateral and bilateral drainage had similar technical and clinical success rates. However, bilateral stents had a higher risk of death and more adverse events. Therefore, unilateral SEMS placement is sufficient for relief of biliary obstruction secondary to cholangiocarcinoma.
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Registered trials
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