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Updated: Nov 21, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Bilateral stenting for hilar biliary obstruction: a meta-analysis of side-by-side versus stent-in-stent
Qiang Cao1, Lin Sun1, Zhi-Qiang Li1
1Department of Radiology, Binzhou People's Hospital, Binzhou, China.
Purpose:
To evaluate the efficacy of stent-in-stent (SIS) and side-by-side (SBS) bilateral stenting for treating malignant hilar biliary obstruction (MHBO).
Material And Methods:
Relevant studies in Pubmed, Embase, and Cochrane Library were identified through June 2020. This meta-analysis was conducted using RevMan v5.3, using relevant endpoint data relating to clinical and technical success, complications, stent dysfunction, and overall survival (OS) rates extracted from these studies.
Results:
We identified six relevant studies which included 315 MHBO patients treated with either SBS (n = 161) or SIS bilateral (n = 154) stenting. We saw no significant difference between these two groups with respect to clinical success (OR: 1.07; 95% CI: 0.46, 2.49, p = .87), complication (HR: 0.12; 95% CI: -0.04, 0.27, p = .15), stent dysfunction (OR: 0.68; 95% CI: 0.42, 1.10, p = .11), or OS (HR: 0.97; 95% CI: 0.82, 1.16, p = .74). However, the SBS group exhibited significantly lower technical success rates (OR: 6.55; 95% CI: 1.10, 38.83, p = .04). Significant heterogeneity was only detected for the endpoint of complication rates (I = 60%).
Conclusion:
These results suggest that SIS bilateral stenting yields better rates of technical success than does SBS bilateral stenting in MHBO patients.
