Retrospective Comparative Study of Side-by-Side and Stent-in-Stent Metal Stent Placement for Hilar Malignant Biliary Obstruction

Ishigaki, Kazunaga; Hamada, Tsuyoshi; Nakai, Yousuke; Isayama, Hiroyuki; Shimoda, Tatsuya; Hakuta, Ryunosuke; Saito, Kei; Saito, Tomotaka; Takahara, Naminatsu; Kogure, Hirofumi; Ito, Yukiko; Yagioka, Hiroshi; Matsubara, Saburo; Akiyama, Dai; Mohri, Dai; Tada, Minoru; Koike, Kazuhiko

doi:10.1007/s10620-020-06155-z

Cited by 38 publications

(64 citation statements)

References 27 publications

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“…A total of 10052 articles were identified through our searches in the MEDLINE, Embase, LILACS, BIREME, and Central Cochrane databases. After the removal of duplicates, evaluation of the titles and abstracts, and text analysis, four retrospective cohort studies[ 29 - 32 ] and one randomized controlled trial (RCT)[ 33 ] were included in the meta-analysis (Figure 2 ). The characteristics of the included studies are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Three[ 29 , 30 , 32 ] of the four retrospective studies presented a moderate overall risk of bias, assessed by the ROBINS-I tool, mainly due to confounding, the bias in the selection of participants, and bias in the selection of the reported results. The other included study[ 31 ] presented a serious risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies evaluated clinical success, namely two cohorts[ 30 , 32 ] (116 patients) and the RCT study[ 33 ] (69 patients). This outcome was similar for both SIS and SBS techniques in the overall analysis (RD = 0.07; 95%CI: -0.05 to 0.18, I 2 = 56%, P =0.26) (Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Three cohorts[ 30 - 32 ] (157 patients) and the RCT study[ 33 ] (69 patients) evaluated early complications. In the overall analysis, both SIS and SBS techniques performed similarly regarding this outcome (RD = -0.09; 95%CI: -0.19 to 0.01, I 2 = 2%, P =0.07) (Figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction — stent-in-stent or side-by-side? A systematic review and meta-analysis

Souza¹,

Ribeiro²,

Funari³

et al. 2021

WJH

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BACKGROUND Biliary drainage, either by the stent-in-stent (SIS) or side-by-side (SBS) technique, is often required when treating a malignant hilar biliary obstruction (MHBO). Both methods differ from each other and have distinct advantages. AIM To compare both techniques regarding their efficacy and safety in achieving drainage of MHBO. METHODS A comprehensive search of multiple electronic databases (MEDLINE, Embase, LILACS, BIREME, Cochrane) was conducted and grey literature from their inception until December 2020 with no restrictions regarding the year of publication or language, since there was at least an abstract in English. The included studies compared SIS and SBS techniques through endoscopic retrograde cholangiopancreatography. Outcomes analyzed included technical and clinical success, early and late adverse events (AEs), stent patency, reintervention, and procedure-related mortality. RESULTS Four cohort studies and one randomized controlled trial evaluating a total of 250 patients (127 in the SIS group and 123 in the SBS group) were included in this study. There were no statistically significant differences between the two groups concerning the evaluated outcomes, except for stent patency, which was higher in the SIS compared with the SBS technique [mean difference (d) = 33.31; 95% confidence interval: 9.73 to 56.90, I 2 = 45%, P = 0.006]. CONCLUSION The SIS method showed superior stent patency when compared to SBS for achieving bilateral drainage in MHBO. Both techniques are equivalent in terms of technical success, clinical success, rates of both early and late AEs, reintervention, and procedure-related mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction — stent-in-stent or side-by-side? A systematic review and meta-analysis

Souza¹,

Ribeiro²,

Funari³

et al. 2021

WJH

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“…There were 24 patients in the SBS group and 40 in the SIS group. For SBS, the 8-mm uncovered Wallflex™ (Boston Scientific Corporation, Marlborough, MA, USA) biliary stents were used and placed across the papilla [8]. For SIS, the 10-mm uncovered Niti-S™ large cell D-type stents (LCD; Taewoong Corp., Gimpo, Korea) were used and placed above the papilla.…”

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confidence: 99%

Endoscopic Stenting for Malignant Hilar Biliary Obstruction: After You Double Down, Are You In or Out?

2020

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Recent advances regarding endoscopic biliary drainage for unresectable malignant hilar biliary obstruction

Kato

Matsumoto

2021

DEN Open

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Biliary drainage for unresectable malignant hilar biliary obstruction (UMHBO) is still associated with a number of controversies to be resolved. The superiority of bilateral drainage in comparison to unilateral drainage has not been proven obviously yet. However, bilateral drainage is necessary to treat obstructive jaundice in some UMHBO patients, and this may be connected with preservation of the functional liver volume. The partial stent‐in‐stent (SIS) method and side‐by‐side (SBS) method developed as bilateral drainage methods. There is no significant difference in the technical or clinical success rates of the SIS and SBS methods. In addition, these methods are comparable in terms of adverse events, patency period, and survival period. On the other hand, reintervention for recurrent biliary obstruction (RBO) after the SBS method seems to be easier in comparison to cases with RBO after the SIS method; however, there is no remarkable difference in the clinical results of these procedures. Endoscopic ultrasound (EUS)‐guided biliary drainage also has become an option for patients with UMHBO. Left hepatic drainage using EUS‐guided hepaticogastrostomy (EUS‐HGS) has become common; however, few studies have reported the results of bridging drainage for the right lobe using the EUS‐HGS route or EUS‐guided hepaticojejunostomy. A few studies addressed the results of newly designed stents, such as the 6‐mm braided metal stent and inside stent. The development of various drainage methods and new devices is necessary for the further advancement of endoscopic biliary drainage for patients with UMHBO, further studies to evaluate those methods and devices are warranted.

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Retrospective Comparative Study of Side-by-Side and Stent-in-Stent Metal Stent Placement for Hilar Malignant Biliary Obstruction

Cited by 38 publications

References 27 publications

Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction — stent-in-stent or side-by-side? A systematic review and meta-analysis

Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction — stent-in-stent or side-by-side? A systematic review and meta-analysis

Endoscopic Stenting for Malignant Hilar Biliary Obstruction: After You Double Down, Are You In or Out?

Recent advances regarding endoscopic biliary drainage for unresectable malignant hilar biliary obstruction

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