title: A comparison of bilateral stenting methods for malignant hilar biliary obstruction.
abstract: OBJECTIVE
  Despite common use of stent-instent methods for endoscopic bilateral metal stenting in malignant hilar obstruction, the longevity of these stents and clinical outcomes of patients who receive them are less well known than for the side-by-side method. We aimed to compare treatment outcomes according to bilateral stenting method.
  
  
  METHODS
  A total of 41 patients were divided into two groups: a bilateral side-by-side metal stenting group (side-by-side group, n=19) and a bilateral stent-in-stent metal stenting group (stent-in-stent group, n=22).
  
  
  RESULTS
  During the study period, successful drainage was achieved in 15 of 19 patients (78.9%) with the side-by-side placement, which did not differ significantly from the proportion with the stent-in-stent placement (18 of 22 patients, 81.8%). The two groups did not differ significantly in rates of early complications (31.6% vs. 22.7%, p=0.725), late complications (36.8% vs. 50.0%, p=0.531) or death (47.4% vs. 54.5%, p=0.647). Comparing stent patency and survival curves according to bilateral stenting type, patients with stent-in-stent placement and those with side-by-side placement did not differ significantly (p=0.771 and p=0.769).
  
  
  CONCLUSIONS
  Our results show no significant difference in clinical outcomes, including stent patency and overall survival, between side-by-side and stent-in-stent bilateral metal stenting in patients with malignant hilar obstruction.
authors.affiliation: Department of Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Yun Hee
authors.initials: YH
authors.lastname: Chung
authors.forename: Jae Uk
authors.initials: JU
authors.lastname: Shin
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Sang Goon
authors.initials: SG
authors.lastname: Shim
mesh_terms: D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications* / Q000401:mortality; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome