ArticleClinical endoscopy2026
Outcomes associated with bilateral plastic versus metal stents for palliation in malignant hilar biliary obstruction: an updated meta-analysis from the United States.
Article in Clinical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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7 authors.
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Abstract
backgroundEndoscopic methods are favorable for palliation of malignant hilar biliary obstruction (MHBO) given its minimally invasive nature. This meta-analysis aimed to evaluate outcomes related to bilateral plastic stents (PS) versus bilateral metal stents (MS) in MHBO palliation.
methodsDatabases were searched through November 2023. Only studies that directly compared bilateral PS and bilateral MS in MHBO were included. The primary outcome was clinical success. Secondary outcomes included technical success, adverse events, postprocedural cholangitis, recurrent biliary obstruction, endoscopic reintervention, and conversion to percutaneous drainage. Mantel-Haenszel pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Statistical heterogeneity was assessed using the I2 statistic and publication bias was assessed using funnel plots.
resultsOne randomized controlled trial and three retrospective cohort studies involving 420 patients were included. Bilateral MS had non-significant superior clinical success, lower rates of reintervention, and lower rates of adverse events, including postprocedural cholangitis. There was no difference in technical success or need for external drainage. Bilateral PS had increased odds of recurrent biliary obstruction (pooled OR, 1.79; 95% CI, 1.15-2.81; p=0.01).
conclusionsThe selection of bilateral PS or MS for MHBO palliation should remain an individualized decision.
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