Drainage strategies for malignant obstructive jaundice

doi:10.3877/cma.j.issn.2095-2015.2025.06.018

Abstract

Abstract:

Malignant obstructive jaundice is caused by the constriction or occlusion of the intrahepatic or extrahepatic bile duct due to the compression of the malignant tumor. Biliary drainage is an important treatment for malignant obstructive jaundice, including endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage and endoscopic ultrasonography-biliary drainage. However, different biliary drainage has its advantages and disadvantages. There is no consensus on the drainage strategy of malignant obstructive jaundice in the domestic and overseas, and there are still disputes about the best drainage method and the indications of preoperative biliary drainage. Therefore, this paper reviews the research progress of drainage strategies for malignant obstructive jaundice in order to provide reference for its clinical treatment.

Key words: Malignant obstructive jaundice, Endoscopic retrograde cholangiopancreatography, Percutaneous transhepatic biliary drainage, Endoscopic ultrasonography-biliary drainage

Jiani Jiang, Yu Zhao, Fujing Lyu, Shutian Zhang. Drainage strategies for malignant obstructive jaundice[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(06): 661-669.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.06.018

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2025/V15/I06/661

References 107

[1]	Costamagna G, Bosǩoski I. Current treatment of benign biliary strictures. Ann Gastroenterol[J]. 2013, 26(1): 37-40.
[2]	Tsuyuguchi T, Takada T, Miyazaki M, et al. Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas. J Hepato-Biliary-Pancreat Surg[J]. 2008, 15(1): 69-73.
[3]	Rizzo A, Ricci AD, Frega G, et al. How to choose between percutaneous transhepatic and endoscopic biliary drainage in Malignant obstructive jaundice: an updated systematic review and meta-analysis[J]. In Vivo, 2020, 34(4): 1701-1714.
[4]	蒋孙路, 黄强, 翟东升, 等. 经内镜逆行胰胆管造影术和经皮肝穿刺胆道引流术治疗恶性梗阻性黄疸的疗效对比[J]. 中国内镜杂志, 2018, 24(1): 75-79.
[5]	陈伟伟, 黄坤, 刘锐, 等. 经皮肝穿刺胆管引流术联合胆道支架植入术治疗高位恶性梗阻性黄疸的效果及预后影响因素分析[J]. 临床肝胆病杂志, 2019, 35(3): 559-564.
[6]	Jin H, Pang Q, Liu H, et al. Prognostic value of inflammation- based markers in patients with recurrent malignant obstructive jaundice treated by reimplantation of biliary metal stents: A retrospective observational study[J]. Med(Baltimore), 2017, 96(3): e5895.
[7]	Vandenabeele LAM, Dhondt E, Geboes KP, et al. Percutaneous stenting in malignant biliary obstruction caused by metastatic disease: clinical outcome and prediction of survival according to tumor type and further therapeutic options[J]. Acta Gastroenterol Belg, 2017, 80(2): 249-255.
[8]	Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
[9]	Celotti A, Solaini L, Montori G, et al. Preoperative biliary drainage in hilar cholangiocarcinoma: Systematic review and meta-analysis[J]. Eur J Surg Oncol, 2017, 43(9): 1628-1635.
[10]	Pu LZ, Singh R, Loong CK, et al. Malignant biliary obstruction: evidence for best practice[J]. Gastroenterol Res Pract, 2016: 3296801.
[11]	Xu X, Li J, Wu J, et al. A systematic review and meta-analysis of intraluminal brachytherapy versus stent alone in the treatment of Malignant obstructive jaundice[J]. Cardiovasc Intervent Radiol, 2018, 41(2): 206-217.
[12]	Moole H, Dharmapuri S, Duvvuri A, et al. Endoscopic versus percutaneous biliary drainage in palliation of advanced Malignant hilar obstruction: A meta-analysis and systematic review[J]. Can J Gastroenterol Hepatol, 2016: 4726078.
[13]	Laleman W, van der Merwe S, Verbeke L, et al. A new intraductal radiofrequency ablation device for inoperable biliopancreatic tumors complicated by obstructive jaundice: the IGNITE-1 study[J]. Endoscopy, 2017, 49(10): 977-982.
[14]	Mukai S, Itoi T, Baron TH, et al. Indications and techniques of biliary drainage for acute cholangitis in updated Tokyo Guidelines 2018[J]. J Hepatobiliary Pancreat Sci, 2017, 24(10): 537-549.
[15]	Sha KH, Liu TG, Yang F, et al. Irradiation stent insertion for inoperable Malignant biliary obstruction: a meta-analysis of randomized controlled trials[J]. Abdom Radiol(NY), 2021, 46(5): 2173-2181.
[16]	Kurniawan J, Hasan I, Gani RA, et al. Mortality-related factors in patients with Malignant obstructive jaundice[J]. Acta Med Indones, 2016, 48(4): 282-288.
[17]	Turan AS, Jenniskens S, Martens JM, et al. Complications of percutaneous transhepatic cholangiography and biliary drainage, a multicenter observational study[J]. Abdom Radiol(NY), 2022, 47(9): 3338-3344.
[18]	Luo J, Shao GL, Yao HX, et al. The efficacy and safety of biliary stenting alone versus stenting combined with iodine-125 seed strand implantation for the treatment of cholangiocarcinoma with Malignant obstructive jaundice: a prospective, nonrandomized, controlled clinical study[J]. Ann Palliat Med, 2022, 11(7): 2422-2431.
[19]	Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization[J]. Ann Surg, 2003, 238(1): 84-92.
[20]	Shen Z, Zhang J, Zhao S, et al. Preoperative biliary drainage of severely obstructive jaundiced patients decreases overall postoperative complications after pancreaticoduodenectomy: A retrospective and propensity score-matched analysis[J]. Pancreatology, 2020, 20(3): 529-536.
[21]	Cho JH, Yoon YS, Kim EJ, et al. A multicenter prospective randomized controlled trial for preoperative biliary drainage with uncovered metal versus plastic stents for resectable periampullary cancer[J]. J Hepatobiliary Pancreat Sci, 2020, 27(10): 690-699.
[22]	Ramanathan R, Borrebach J, Tohme S, et al. Preoperative biliary drainage is associated with increased complications after liver resection for proximal cholangiocarcinoma[J]. J Gastrointest Surg, 2018, 22(11): 1950-1957.
[23]	Uppa DS, Wang AY. Advances in endoscopic retrograde cholangio-pancreatography for the treatment of cholangiocarcinoma [J]. World J Gastrointest Endosc, 2015, 7(7): 675-687.
[24]	She WH, Cheung TT, Ma KW, et al. Impact of preoperative biliary drainage on postoperative outcomes in hilar cholangiocarcinoma[J]. Asian J Surg, 2022, 45(4): 993-1000.
[25]	Gao Z, Wang J, Shen S, et al. The impact of preoperative biliary drainage on postoperative outcomes in patients with Malignant obstructive jaundice: a retrospective analysis of 290 consecutive cases at a single medical center[J]. World J Surg Oncol, 2022, 20(1): 7.
[26]	Miller CS, Barkun AN, Martel M, et al. Endoscopic ultrasound-guided biliary drainage for distal Malignant obstruction: a systematic review and meta-analysis of randomized trials[J]. Endosc Int Open, 2019, 7(11): 1563-1573.
[27]	邢颖, 张洪义. 恶性梗阻性黄疸术前减黄的方式及必要性探讨[J]. 中国医刊, 2019, 37(7): 704-707.
[28]	龚建平, 程瑶. 恶性梗阻性黄疸术前减黄的标准、指征及效果[J]. 中国普外基础与临床杂志, 2018, 25(7): 781-783.
[29]	Qumseya BJ, Jamil LH, Elmunzer BJ, et al. ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction[J]. Gastrointest Endosc, 2021, 94(2): 222-234.
[30]	Dumonceau J. M. , Tringali A. , Papanikolaou I. S. , et al. Endoscopic biliary stenting: Indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy(ESGE) Clinical Guideline—Updated October 2017[J]. Endoscopy, 2018, 50(9): 910-930.
[31]	Pietrzak Jakub, Przybyłkowski Adam. Endoscopic Treatment of Malignant Hilar Biliary Obstruction[J]. Cancers(Basel), 2023, 15(24): 5819
[32]	Talukder S, Behera A, Tandup C, et al. Isolated implant metastasis in chest wall due to seeding of transpleurally placed PTBD catheter tract in a case of hilar cholangiocarcinoma[J]. BMJ Case Rep, 2017: bcr2017219864.
[33]	Bian Cnogwen, Fang Yuan, Xia Jun, et al. Is percutaneous drainage better than endoscopic drainage in the management of patients with malignant obstructive jaundice? A meta-analysis of RCTs[J]. Front Oncol, 2023, 13: 1105728.
[34]	Marcus SG, Dobryansky M, Shamamian P, et al. Endoscopic biliary drainage before pancreaticoduodenectomy for periampullary malignancies[J]. J Clin Gastroenterol, 1998, 26(2): 125-129.
[35]	Berry R, Han JY, Tabibian JH. Difficult biliary cannulation: Historical perspective, practical updates, and guide for the endoscopist[J]. World J Gastrointest Endosc, 2019, 11(1): 5-21.
[36]	Wang Yanzhao, Zhao Xuebo, She Yan, et al. The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis. Front Oncol, 2024, 14: 1370383.
[37]	Páez-Carpio A, Hessheimer A, Bermúdez P, et al. Percutaneous transhepatic biliary drainage for biliary obstruction in perihilar cholangiocarcinoma: A 10-year analysis of safety and outcomes using the CCI index[J]. Langenbecks Arch Surg, 2023, 408(1): 109.
[38]	Duan Feng, Cui Li, Bai Yanhua, et al. Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis[J]. Cancer Imaging, 2017, 17(1): 27.
[39]	Dumonceau J-M, Macias-Gomez C. Endoscopic management of complications of chronic pancreatitis[J]. World J Gastroenterol, 2013, 19(42): 7308-7315.
[40]	Shabunin AV, Tavobilov MM, Lebedev SS, et al. Mechanisms and prevention of biliary stent occlusion[J]. Khirurgiia(Mosk), 2020(5): 70-75.
[41]	Langerth A, Isaksson B, Karlson BM, et al. ERCP-related perforations: a population-based study of incidence, mortality, and risk factors[J]. Surg Endosc, 2020, 34(5): 1939-1947.
[42]	Tapping CR, Byass OR, Cast JE. Percutaneous transhepatic biliary drainage(PTBD) with or without stenting-complications, re-stent rate and a new risk stratification score[J]. Eur Radiol, 2011, 21(9): 1948-1955.
[43]	Voiosu T, Boskoski I, Voiosu AM, et al. Impact of trainee involvement on the outcome of ERCP procedures: results of a prospective multicenter observational trial[J]. Endoscopy, 2020, 52(2): 115-122.
[44]	Komaya K, Ebata T, Fukami Y, et al. Percutaneous biliary drainage is oncologically inferior to endoscopic drainage: a propensity score matching analysis in resectable distal cholangiocarcinoma[J]. J Gastroenterol, 2016, 51(6): 608-619.
[45]	Wang L, Lin N, Xin, et al. A systematic review of the comparison of the incidence of seeding metastasis between endoscopic biliary drainage and percutaneous transhepatic biliary drainage for resectable malignant biliary obstruction[J]. World J Surg Oncol, 2019, 17(1): 116.
[46]	Saluja SS, Gulati M, Garg PK, et al. Endoscopic or percutaneous biliary drainage for gallbladder cancer: a randomized trial and quality of life assessment[J]. Clin Gastroenterol Hepatol, 2008, 6(8): 944-950.
[47]	van der Merwe Schalk W, van Wanrooij Roy L J, Bronswijk Michiel, et al. Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy(ESGE) Guideline[J]. Endoscopy, 2022, 54(2): 185-205.
[48]	Cho DH, Lee SS, Oh D, et al. Long-term outcomes of a newly developed hybrid metal stent for EUS-guided biliary drainage(with videos)[J]. Gastrointest Endosc, 2017, 85(5): 1067-1075.
[49]	Kawakubo K, Isayama H, Kato H et al. Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan[J]. J Hepatobiliary Pancreat Sci, 2014, 21(5): 328-334.
[50]	Giovannini M, Moutardier V, Pesenti C, et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage[J]. Endoscopy, 2001, 33(10): 898-900.
[51]	Dhir V, Itoi T, Khashab MA, et al. Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach[J]. Gastrointest. Endosc, 2015, 81(4): 913-923.
[52]	Sundaram S, Dhir V. EUS-guided biliary drainage for malignant hilar biliary obstruction: A concise review[J]. Endosc Ultrasound, 2021; 10(3): 154-160.
[53]	Nakai Y, Isayama H, Yamamoto N, et al. Indications for endoscopic ultrasonography(EUS)-guided biliary intervention: does EUS always come after failed endoscopic retrograde cholangiopancreatography? [J]. Dig Endosc, 2017, 29(2): 218-225.
[54]	Poincloux L, Rouquette O, Buc E, et al. Endoscopic ultrasound-guided biliary drainage after failed ERCP: cumulative experience of 101 procedures at a single center[J]. Endoscopy, 2015, 47(9): 794-801.
[55]	Khashab MA, Messallam AA, Penas I, et al. International multicenter comparative trial of transluminal EUS-guided biliary drainage via hepatogastrostomy vs. choledochoduodenostomy approaches[J]. Endosc Int Open, 2016, 4(2): 175-181.
[56]	Guo J, Sun S, Liu X, et al. Endoscopic ultrasound-guided biliary drainage using a fully covered metallic stent after failed endoscopic retrograde cholangiopancreatography[J]. Gastroenterol Res Pract, 2016: 9469472.
[57]	Minaga K, Ogura T, Shiomi H, et al. Comparison of the efficacy and safety of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for malignant distal biliary obstruction: Multicenter, randomized, clinical trial[J]. Dig Endosc, 2019, 31(5): 575-582.
[58]	Ogura T, Chiba Y, Masuda D, et al. Comparison of the clinical impact of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction[J]. Endoscopy, 2016, 48(2): 156-163.
[59]	Han SY, Kim SO, So H, et al. EUS-guided biliary drainage versus ERCP for first-line palliation of malignant distal biliary obstruction: A systematic review and meta-analysis[J]. Sci Rep, 2019, 9(1): 16551.
[60]	ImaiH, KitanoM, OmotoSetal. EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP[J]. Gastrointest Endosc, 2016, 84(1): 147-151.
[61]	Issa D, Irani S, Law R, et al. Endoscopic ultrasound-guided gallbladder drainage as a rescue therapy for unresectable malignant biliary obstruction: a multicenter experience[J]. Endoscopy, 2021, 53(8): 827-831.
[62]	Wang K, Zhu J, Xing L, et al. Assessment of efficacy and safety of EUS-guided biliary drainage: a systematic review[J]. Gastrointest Endosc, 2016, 83(6): 1218-1227.
[63]	Dhir V, Bhandari S, Bapat M, et al. Comparison of transhepatic and extrahepatic routes for EUS-guided rendezvous procedure for distal CBD obstruction[J]. United European Gastroenterol J, 2013, 1(2): 103-108.
[64]	Iwashita T, Lee JG, Shinoura S, et al. Endoscopic ultrasound-guided rendezvous for biliary access after failed cannulation[J]. Endoscopy, 2012, 44(1): 60-65.
[65]	Khashab MA, Valeshabad AK, Afghani E, et al. A comparative evaluation of EUS-guided biliary drainage and percutaneous drainage in patients with distal malignant biliary obstruction and failed ERCP[J]. Dig Dis Sci, 2015, 60(2): 557-565.
[66]	Sharaiha RZ, Kumta NA, Desai AP, et al. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography[J]. Surg Endosc, 2016, 30(12): 5500-5505.
[67]	Lee TH, Choi JH, Park DH, et al. Similar efficacies of endoscopic ultrasound-guided transmural and percutaneous drainage for malignant distal biliary obstruction[J]. Clin Gastroenterol Hepatol, 2016, 14(7): 1011-1019.
[68]	Sharaiha RZ, Khan MA, Kamal F, et al. Efficacy and safety of EUS-guided biliary drainage in comparison with percutaneous biliary drainage when ERCP fails: a systematic review and meta-analysis[J]. Gastrointest Endosc, 2017, 85(5): 904-914.
[69]	Vanella G, Bronswijk M, Maleux G, et al. EUS-guided intrahepatic biliary drainage: a large retrospective series and subgroup comparison between percutaneous drainage in hilar stenoses or postsurgical anatomy[J]. Endosc Int Open, 2020, 8(12): 1782-1794.
[70]	Minaga K, Takenaka M, Kitano M, et al. Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention[J]. Surg Endosc, 2017, 31(11): 4764-4772.
[71]	Moryoussef F, Sportes A, Leblanc S, et al. Is EUS-guided drainage a suitable alternative technique in case of proximal biliary obstruction? [J]. Therap Adv Gastroenterol, 2017, 10(7): 537-544.
[72]	Bang JY, Navaneethan U, Hasan M, et al. Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer: a randomized trial(with videos)[J]. Gastrointest Endosc, 2018, 88(1): 9-17.
[73]	Paik WH, Lee TH, Park DH, et al. EUS-guided biliary drainage versus ERCP for the primary palliation of malignant biliary obstruction: a multicenter randomized clinical trial[J]. Am J Gastroenterol, 2018, 113(7): 987-997.
[74]	Park JK, Woo YS, Noh DH, et al. Efficacy of EUS-guided and ERCP-guided biliary drainage for malignant biliary obstruction: prospective randomized controlled study[J]. Gastrointest Endosc, 2018, 88(2): 277-282.
[75]	Jin Zheng, Wei Yaping, Lin Huapeng, et al. Endoscopic ultrasound-guided versus endoscopic retrograde cholangiopancreatography-guided biliary drainage for primary treatment of distal malignant biliary obstruction-A systematic review and meta-analysis[J]. Dig Endosc, 2020, 32(1): 16-26.
[76]	Wang Yaoqun, Wen Ningyuan, Xiong Xianze, et al. Biliary drainage in malignant biliary obstruction: an umbrella review of randomized controlled trials[J]. Front Oncol, 2023, 13: 1235490.
[77]	Xia MX, Cai XB, Pan YL, et al. Optimal stent placement strategy for malignant hilar biliary obstruction: A large multicenter parallel study[J]. Gastrointest. Endosc, 2020, 91(5): 1117-1128.
[78]	Almadi MA, Barkun A, Martel M. Plastic vs. Self-expandable metal stents for palliation in malignant biliary obstruction: A series of META-analyses[J]. Am J Gastroenterol, 2017, 112(2): 260-273.
[79]	Watanabe J, Miki A, Sasanuma H, et al. METAl vs plastic stents for preoperative biliary drainage in patients with periampullary cancer: An updated systematic review and META-analysis[J]. J Hepatobiliary Pancreat Sci, 2023; 30(1): 6-20.
[80]	Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2. 2021, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2021, 19(4): 439-457.
[81]	Okusaka T, Nakamura M, Yoshida M, et al. Clinical practice guidelines for pancreatic cancer 2019 from the Japan pancreas society: A synopsis[J]. Pancreas, 2020, 49(3): 326-335.
[82]	Müller PC, Hodson J, Kuemmerli C, et al. Effect of time to surgery in resectable pancreatic cancer: a systematic review and META-analysis[J]. Langenbecks Arch Surg, 2020, 405(3): 293-302.
[83]	李鹏, 王拥军, 王文海, 等. ERCP诊治指南(2018版)[J]. 中国实用内科杂志, 2018, 38(11): 1041-1072.
[84]	Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence: indirectnes[J]s. J Clin Epidemiol, 2011, 64(12): 1303-1310.
[85]	Yamashita Y, Tachikawa A, Shimokawa T, et al. Covered versus uncovered METAl stent for endoscopic drainage of a Malignant distal biliary obstruction: META-analysis[J]. Dig Endosc, 2022, 34(5): 938-951.
[86]	Tringali A, Hassan C, Rota M, et al. Covered vs. uncovered self-expandable METAl stents for Malignant distal biliary strictures: a systematic review and META-analysis[J]. Endoscopy[J]. 2018, 50(6): 631-641.
[87]	Mori H, Kawashima H, Ohno E, et al. Comparison of an Inside Stent and a Fully Covered Self-Expandable Metallic Stent as Preoperative Biliary Drainage for Patients with Resectable Perihilar Cholangiocarcinoma [J]. Can J Gastroenterol Hepatol, 2022: 3005210.
[88]	Hamada T, Nakai Y, Isayama H, et al. Antireflux metal stent for biliary obstruction: Any benefits[J]. Dig Endosc, 2021, 33(3): 310-320.
[89]	Hamada T, Isayama H, Nakai Y, et al. Antireflux covered metal stent for nonresectable distal Malignant biliary obstruction: Multicenter randomized controlled trial[J]. Dig Endosc, 2019, 31(5): 566-574.
[90]	Renno A, Abdel-Aziz Y, Ahmed T, et al. Antireflux valve metal stent versus conventional self-expandable metal stent in distal Malignant biliary obstruction: a systematic review and META-analysis[J]. Ann Gastroenterol, 2019, 32(6): 605-613.
[91]	Chino K, Silvain D, Grace A, et al. Feasibility and safety of outpatient brachytherapy in 37 patients with brain tumors using the GliaSite Radiation Therapy System[J]. Med Phys, 2008, 35(7): 3383-3388.
[92]	Xiang Y, Lu S, Li Y, et al. Iodine-125 seeds combined with biliary stent placement versus stent placement alone for unresectable Malignant biliary obstruction: A meta-analysis of randomized controlled trials[J]. J Cancer, 2021, 12(5): 1334-1342.
[93]	Li ZM, Jiao DC, Han XW, et al. Preliminary application of brachytherapy with double-strand 125I seeds and biliary drainage for Malignant obstructive jaundice[J]. Surg Endosc, 2022, 36(7): 4932-4938.
[94]	Jang SI, Lee KT, Choi JS, et al. Efficacy of a paclitaxel-eluting biliary metal stent with sodium caprate in Malignant biliary obstruction: a prospective randomized comparative study[J]. Endoscopy, 2019, 51(9): 843-851.
[95]	Rerknimitr R. , Angsuwatcharakon P. , Ratanachu-ek T. , et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J. Gastroenterol. Hepatol, 2013, 28(4): 593-607.
[96]	Chen ZK, Zhang W, Xu YS, et al. Unilateral Versus Side-By-Side Metal Stenting for Malignant Hilar Biliary Obstruction: A Meta-Analysis[J]. J Laparoendosc Adv Surg Tech A, 2021, 31(2): 203-209.
[97]	Yang F. , Wang X. M. , Xia F. F. , et al. Endoscopic metal stenting for malignant hilar biliary obstruction: An update meta-analysis of unilateral versus bilateral stenting[J]. Wideochir Inne Tech Maloinwazyjne, 2021, 16(3): 472-481.
[98]	Cao Q, Sun L, Li ZQ, et al. Bilateral stenting for hilar biliary obstruction: A meta-analysis of side-by-side versus stent-in-stent. Minim. Invasive Ther[J]. Allied Technol, 2022, 31(4): 525-530.
[99]	Ishigaki K, Hamada T, Nakai Y, et al. Retrospective Comparative Study of Side-by-Side and Stent-in-Stent Metal Stent Placement for Hilar Malignant Biliary Obstruction[J]. Dig Dis Sci, 2020, 65(12): 3710-3718.
[100]	De Souza GMV, Ribeiro IB, Funari MP, et al. Endoscopic retrograde cholangiopancreatography drainage for palliation of malignant hilar biliary obstruction-Stent-in-stent or side-by-side? A systematic review and meta-analysis[J]. World J Hepatol, 2021, 13(5): 595-610.
[101]	Matsumoto K. , Kato H. , Morimoto K. , et al. Comparison of Bilateral and Trisegment Drainage in Patients with High-Grade Hilar Malignant Biliary Obstruction: A Multicenter Retrospective Study[J]. Gut Liver, 2023, 17(1): 170-178.
[102]	Maruki Y. , Hijioka S. , Wu S. Y. S. , et al. Novel endoscopic technique for trisegment drainage in patients with unresectable hilar malignant biliary strictures(with video)[J]. Gastrointest Endosc, 2020, 92(3): 763-769.
[103]	Lu J, Guo JH, Zhu HD, et al. Palliative treatment with radiation-emitting metallic stents in unresectable Bismuth type Ⅲ or Ⅳ hilar cholangiocarcinoma[J]. ESMO Open, 2017, 2(4): e000242.
[104]	Keplinger KM, Bloomston M. Anatomy and embryology of the biliary tract[J]. Surg Clin N Am, 2014, 94(2): 203-217.
[105]	Vienne A, Hobeika E, Gouya H, et al. Prediction of drainage effectiveness during endoscopic stenting of malignant hilar strictures: The role of liver volume assessment[J]. Gastrointest Endosc, 2010, 72(4): 728-735.
[106]	Lee TH, Kim TH, Moon JH, et al. Bilateral versus unilateral placement of metal stents for inoperable high-grade malignant hilar biliary strictures: A multicenter, prospective, randomized study(with video)[J]. Gastrointest Endosc, 2017, 86(5): 817-827.
[107]	Hosokawa I, Takayashiki T, Ohtsuka M. Fusion imaging of real-time ultrasonography and computed-tomography-assisted puncture of the bile duct of segment 6 for Bismuth-Corlette type Ⅳ perihilar cholangiocarcinoma[J]. Asian J Surg, 2023, 46(2): 907-908.

Please choose a citation manager

Content to export