title: Bilateral stenting methods for hilar biliary obstructions.
abstract: OBJECTIVE
  There is no consensus regarding the most appropriate methods (i.e., the side-by-side versus the stent-in-stent technique) for placing bilateral stents for malignant hilar biliary obstructions. We aimed to perform a quantitative review of the published data regarding the clinical efficacy of the side-by-side and stent-in-stent bilateral drainage techniques for hilar biliary obstructions.
  
  
  METHODS
  A comprehensive search of several databases was conducted and a fixed-effects or random-effects model was used to pool the data from all of the study end-points.
  
  
  RESULTS
  Four clinical trials were identified. A comparison of the side-by-side and stent-in-stent groups revealed no significant differences with respect to the rates of successful placement, successful drainage, early complications, late complications and stent occlusions. There were also no significant inter-group differences in stent patency and patient survival and no publication bias was observed.
  
  
  CONCLUSIONS
  The performance of the side-by-side technique appears to be similar to that of the stent-in-stent technique for bilateral drainage in patients with malignant hilar biliary obstructions.
authors.affiliation: Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Wandong
authors.initials: W
authors.lastname: Hong
authors.affiliation: Department of Radiology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Shanxi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Qihuai
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Huichun
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Intensive Care Unit, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Jingye
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Qingke
authors.initials: Q
authors.lastname: Huang
mesh_terms: D002779:Cholestasis / Q000401:mortality / Q000628:therapy*; D002986:Clinical Trials as Topic; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017594:Publication Bias; D015203:Reproducibility of Results; D015607:Stents; D016896:Treatment Outcome