Observational studyJournal of hepato-biliary-pancreatic sciences2026
Above- Versus Across-The-Papilla Plastic Stent Placement for Malignant Hilar Biliary Obstruction in Unresectable Biliary Tract Cancer: A Multicentre IPTW Analysis.
Observational study in Journal of hepato-biliary-pancreatic sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMaintaining effective biliary drainage is crucial in the era of prolonged chemotherapy for biliary tract cancer (BTC). Plastic stents (PS) are widely used in malignant hilar biliary obstruction (MHBO); nonetheless, the optimal placement (above- vs. across-the-papilla) remains controversial.
methodsIn this multicentre retrospective study, 246 patients with unresectable BTC-related MHBO who underwent clinically successful PS placement between April 2016 and August 2024 were analyzed. Patients were classified into the above-the-papilla (n = 197) and across-the-papilla (n = 49) groups. Baseline imbalances were adjusted using inverse probability of treatment weighting (IPTW) with "average treatment effect on the treated". Covariates included age, sex, primary disease, Bismuth classification, cholangitis, prior drainage, and number of stents. The primary outcome was time to recurrent biliary obstruction (TRBO); secondary outcomes included overall survival (OS) and adverse events (AEs).
resultsAfter IPTW adjustment, effective sample sizes were 47.6 (above-the-papilla group) and 49.0 (across-the-papilla group). The median TRBO was significantly longer in the above-the-papilla group (114 vs. 66 days; p = 0.02), with a hazard ratio of 1.62 (95% confidence interval: 0.97-2.70). OS (457 vs. 366 days; p = 0.99) and AE rates were comparable.
conclusionsAbove-the-papilla PS placement may prolong stent patency without compromising safety in patients with unresectable BTC-related MHBO.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.