Evidence map›Paper›PMID 40866729›Full record

SynthesisDigestive diseases and sciences2026

Safety and Efficacy of Unilateral and Bilateral Stenting for Hilar Biliary Obstruction: An Updated Systematic Review and Meta-Analysis.

Yuanzhi Ni, Kamran Ali, Penghao Tang, Khizar Hayat, Zhiwen Cheng, Benfeng Xu, Zhiwen Qin, Wu Zhang

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis 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

8 authors.

Yuanzhi NiDepartment of Hepatobiliary Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, Zhejiang, China.
Kamran AliDepartment of Surgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang, China.
Penghao TangThe Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Khizar HayatDepartment of Surgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang, China.
Zhiwen ChengZhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Benfeng XuGraduate School of Zhejiang, Chinese Medical University, Hangzhou, China.
Zhiwen QinGraduate School of Zhejiang, Chinese Medical University, Hangzhou, China.
Wu ZhangDepartment of Hepatobiliary Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, Zhejiang, China. wu.zhang@shulan.com.

Funding

This research was supported by the The National Key R&D Program of China (NO. 2022YFC2304405)
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe optimal stenting strategy for malignant hilar biliary obstruction (MHBO) remains controversial, with debate about the choice between unilateral (UL) and bilateral (BL) stenting. This meta-analysis compares the safety and efficacy of UL and BL stenting in treating MHBO.

methodsWe searched PubMed, Embase, Scopus, and others until February 2024 for studies comparing UL and BL stenting for MHBO. Technical and clinical success were our primary outcomes. Analyses calculated pooled risk ratios (RR) or hazard ratios (HR) with 95% confidence intervals using random-effects models.

resultsA total of 21 studies (5 RCTs and 16 observational studies) involving 2567 patients (1224 in UL and 1343 in BL group) were included in this meta-analysis. UL showed higher clinical success rates RR (0.97, 95% CI 0.94-0.99, p = 0.01) and similar technical success rates (1.01, 95% CI 1.00-1.03, p = 0.09) than UL. Whereas BL stenting was associated with higher early and similar late adverse event rates (0.59, 95% CI 0.45-0.77, P = 0.0001 and 0.87, 95% CI 0.74-1.03, p = 0.11). Significant differences in stent patency HR (0.76, 95% CI 0.66-0.87, p = 0.0001) and overall survival (0.77, 95% CI 0.68-0.87, p < 0.0001) were observed between the two stenting procedures. Subgroup analysis showed that endoscopic BL metal stenting showed improved results.

conclusionsBL stenting for MHBO improves stent patency and survival over UL stenting, as well as better results combined with chemotherapy, but it involves the high risk of early adverse events.

trial registrationThis systematic review and meta-analysis was registered at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ) with registration number CRD42024523434.

Indexed as

Bile Duct NeoplasmsCholestasisStentsHumansTreatment OutcomeBilateralCholangiocarcinomaMalignant hilar biliary obstructionStent patencySurvivalUnilateral

Identifiers

PMID40866729

What OpenQuestion holds

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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.