{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T16:21:41Z","timestamp":1764174101631},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T00:00:00Z","timestamp":1414022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bilateral self\u2010expandable metallic stent (<jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content>) placement for the management of unresectable malignant hilar biliary obstruction (<jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>) is technically challenging to perform using the existing metallic stents with thick delivery systems. The recently developed 6\u2010<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>r delivery systems could facilitate a single\u2010step simultaneous side\u2010by\u2010side placement through the accessory channel of the duodenoscope. The aim of this study was to evaluate the feasibility of this procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ay and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>eptember 2013, 13 consecutive patients with <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content> underwent a single\u2010step simultaneous side\u2010by\u2010side placement of <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> with the 6\u2010<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>r delivery system. The technical success rate, stent patency, and rate of complications were evaluated from the prospectively collected database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Technical success was achieved in 11 (84.6%, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 57.8\u201395.8) patients. The median procedure time was 25\u2009min. Early and late complications were observed in 23% (one segmental cholangitis and two liver abscesses) and 15% (one segmental cholangitis and one cholecystitis) patients, respectively. Median dysfunction free patency was 263 days (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 37\u2013263). Five patients (38%) experienced stent occlusion that was successfully managed by endoscopic stent placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A single\u2010step simultaneous side\u2010by\u2010side placement of <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> with a 6\u2010<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>r delivery system was feasible for the management of <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.173","type":"journal-article","created":{"date-parts":[[2014,10,24]],"date-time":"2014-10-24T00:15:06Z","timestamp":1414109706000},"page":"151-155","source":"Crossref","is-referenced-by-count":28,"title":["Single\u2010step simultaneous side\u2010by\u2010side placement of a self\u2010expandable metallic stent with a 6\u2010<scp>F<\/scp>r delivery system for unresectable malignant hilar biliary obstruction: a feasibility study"],"prefix":"10.1002","volume":"22","author":[{"given":"Kazumichi","family":"Kawakubo","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Hokkaido University Hospital  Kita 14, Nishi 5, Kita\u2010ku Sapporo Hokkaido 060\u20108648 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Kuwatani","sequence":"additional","affiliation":[{"name":"Division of Endoscopy Hokkaido University Hospital  Sapporo Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiki","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Hokkaido University Hospital  Kita 14, Nishi 5, Kita\u2010ku 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