{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:15:35Z","timestamp":1776903335498,"version":"3.51.2"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 44 patients who underwent initial inside\u2010stent placement above the sphincter of Oddi from April 2017 to December 2022, 42 with the resolution of jaundice (clinical success rate, 95.5%) were retrospectively analyzed. Univariate and multivariate logistic regression analysis identified factors associated with stent patency duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Univariate analysis revealed significant differences in the drainage method (406 days for unilateral drainage vs. 305 days for bilateral drainage of the right and left liver lobes, <jats:italic>p<\/jats:italic> = 0.022) with or without chemotherapy (406 days with vs. 154 days without, <jats:italic>p<\/jats:italic> = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (<jats:italic>p<\/jats:italic> = 0.031) and chemotherapy (<jats:italic>p<\/jats:italic> = 0.048) identified as independent factors associated with prolonged stent patency. Early adverse events were observed in two patients (4.8%; one cholangitis, one pancreatitis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inside\u2010stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.<\/jats:p><\/jats:sec>","DOI":"10.1002\/deo2.404","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T15:59:05Z","timestamp":1721059145000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction"],"prefix":"10.1002","volume":"5","author":[{"given":"Fumimasa","family":"Tomooka","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5794-1512","authenticated-orcid":false,"given":"Koh","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nara Medical University  Nara 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