{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:44:50Z","timestamp":1785689090155,"version":"3.56.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100023476","name":"British Society of Interventional radiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023476","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000398","name":"Royal College of Radiologists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000398","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000371","name":"Circulation Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000371","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Intervent Radiol"],"DOI":"10.1007\/s00270-026-04461-z","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:06:34Z","timestamp":1779311194000},"page":"1575-1583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Suprapapillary Versus Transpapillary Biliary Stent Placement for Palliation of Malignant Hilar Biliary Obstruction"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1457-0659","authenticated-orcid":false,"given":"Frances","family":"Sheehan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Al-Rekabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeral","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasim","family":"Hakim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Tait","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Graham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alsafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"6","key":"4461_CR1","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1067\/mge.2001.114714","volume":"53","author":"S Sherman","year":"2001","unstructured":"Sherman S. Endoscopic drainage of malignant hilar obstruction: is one biliary stent enough or should we work to place two? Gastrointest Endosc. 2001;53(6):681\u20134.","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"4461_CR2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/BF01658484","volume":"12","author":"H Bismuth","year":"1988","unstructured":"Bismuth H, Castaing D, Traynor O. Resection or palliation: priority of surgery in the treatment of hilar cancer. World J Surg. 1988;12(1):39\u201347.","journal-title":"World J Surg"},{"issue":"4","key":"4461_CR3","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1111\/jgh.12128","volume":"28","author":"R Rerknimitr","year":"2013","unstructured":"Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, Khor CJL, Ponnudurai R, Moon JH, et al. Asia\u2013Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol. 2013;28(4):593\u2013607.","journal-title":"J Gastroenterol Hepatol"},{"issue":"09","key":"4461_CR4","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1055\/a-0659-9864","volume":"50","author":"JM Dumonceau","year":"2018","unstructured":"Dumonceau JM, Tringali A, Papanikolaou I, Blero D, Mangiavillano B, Schmidt A, et al. Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline \u2013 Updated October 2017. Endoscopy. 2018;50(09):910\u201330.","journal-title":"Endoscopy"},{"issue":"5","key":"4461_CR5","doi-asserted-by":"publisher","first-page":"AB139","DOI":"10.1016\/j.gie.2013.04.049","volume":"77","author":"JN Cho","year":"2013","unstructured":"Cho JN, Han J, Kim HG, Shin IMH, Park SH, Moon JH, et al. 287 prospective randomized trial comparing covered metal stent placed above and across the sphincter of Oddi in malignant biliary obstruction. Gastrointest Endosc. 2013;77(5):AB139\u201340.","journal-title":"Gastrointest Endosc"},{"issue":"6","key":"4461_CR6","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1016\/S0016-5107(98)70038-0","volume":"48","author":"FM Pedersen","year":"1998","unstructured":"Pedersen FM, Lassen AT, Schaffalitzky de Muckadell OB. Randomized trial of stent placed above and across the sphincter of Oddi in malignant bile duct obstruction. Gastrointest Endosc. 1998;48(6):574\u20139.","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"4461_CR7","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.gie.2024.03.024","volume":"100","author":"SW Ko","year":"2024","unstructured":"Ko SW, Joo HD, Song TJ, Kim S, Choi SJ, Oh CH, et al. Impact of the suprapapillary method on patency in distal malignant biliary obstruction: a multicenter randomized controlled trial. Gastrointest Endosc. 2024;100(4):679-687.e1.","journal-title":"Gastrointest Endosc"},{"issue":"5","key":"4461_CR8","doi-asserted-by":"publisher","first-page":"2869","DOI":"10.1007\/s00464-021-08576-x","volume":"36","author":"A Kurita","year":"2022","unstructured":"Kurita A, Uza N, Asada M, Yoshimura K, Takemura T, Yazumi S, et al. Stent placement above the sphincter of Oddi is a useful option for patients with inoperable malignant hilar biliary obstruction. Surg Endosc. 2022;36(5):2869\u201378.","journal-title":"Surg Endosc"},{"issue":"11","key":"4461_CR9","doi-asserted-by":"publisher","first-page":"8178","DOI":"10.1007\/s00464-023-10464-5","volume":"37","author":"H Yang","year":"2023","unstructured":"Yang H, Deng J, Hu Y, Hong J. Meta-analysis on clinical outcomes of suprapapillary versus transpapillary stent insertion in malignant biliary obstruction. Surg Endosc. 2023;37(11):8178\u201395.","journal-title":"Surg Endosc"},{"issue":"3","key":"4461_CR10","doi-asserted-by":"publisher","first-page":"898","DOI":"10.3390\/jcm12030898","volume":"12","author":"N Kov\u00e1cs","year":"2023","unstructured":"Kov\u00e1cs N, P\u00e9csi D, Sipos Z, Farkas N, F\u00f6ldi M, Hegyi P, et al. Suprapapillary biliary stents have longer patency times than transpapillary stents\u2014a systematic review and meta-analysis. J Clin Med. 2023;12(3):898.","journal-title":"J Clin Med"},{"issue":"2","key":"4461_CR11","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1080\/17474124.2022.2027239","volume":"16","author":"C Zeng","year":"2022","unstructured":"Zeng C, Zhang Y, Yang H, Hong J. Prevention of pancreatitis after stent implantation for distal malignant biliary strictures: systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol. 2022;16(2):141\u201354.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"8","key":"4461_CR12","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1016\/j.jvir.2023.03.031","volume":"34","author":"AP Borges","year":"2023","unstructured":"Borges AP, Silva AV, Donato P. Comparison between suprapapillary and transpapillary uncovered self-expandable metallic stent placement for perihilar cholangiocarcinoma. J Vasc Interv Radiol. 2023;34(8):1400\u20138.","journal-title":"J Vasc Interv Radiol"},{"issue":"1","key":"4461_CR13","doi-asserted-by":"publisher","first-page":"261","DOI":"10.2214\/AJR.09.2474","volume":"194","author":"YL Sol","year":"2010","unstructured":"Sol YL, Kim CW, Jeon UB, Lee NK, Kim S, Kang DH, et al. Early infectious complications of percutaneous metallic stent insertion for malignant biliary obstruction. Am J Roentgenol. 2010;194(1):261\u20135.","journal-title":"Am J Roentgenol"},{"issue":"4","key":"4461_CR14","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s00270-001-0030-x","volume":"24","author":"AA Hatzidakis","year":"2001","unstructured":"Hatzidakis AA, Tsetis D, Chrysou E, Sanidas E, Petrakis J, Gourtsoyiannis NC. Nitinol stents for palliative treatment of malignant obstructive jaundice: should we stent the Sphincter of Oddi in every case? Cardiovasc Intervent Radiol. 2001;24(4):245\u20138.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"45","key":"4461_CR15","doi-asserted-by":"publisher","first-page":"e7475","DOI":"10.1097\/MD.0000000000007475","volume":"96","author":"XN Mao","year":"2017","unstructured":"Mao XN, Lu ZM, Wen F, Liang HY, Guo QY. Bare-metal stents across the Vater\u2019s ampulla is a safe method for patients with lower bile duct obstruction. Medicine. 2017;96(45):e7475.","journal-title":"Medicine"},{"issue":"4","key":"4461_CR16","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.jvir.2014.11.043","volume":"26","author":"JH Jo","year":"2015","unstructured":"Jo JH, Park BH. Suprapapillary versus transpapillary stent placement for malignant biliary obstruction: which is better? J Vasc Interv Radiol. 2015;26(4):573\u201382.","journal-title":"J Vasc Interv Radiol"},{"issue":"3","key":"4461_CR17","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.jvir.2014.11.008","volume":"26","author":"X Huang","year":"2015","unstructured":"Huang X, Shen L, Jin Y, Chen L, Zhou D, Xu G, et al. Comparison of uncovered stent placement across versus above the main duodenal papilla for malignant biliary obstruction. J Vasc Interv Radiol. 2015;26(3):432\u20137.","journal-title":"J Vasc Interv Radiol"},{"issue":"3","key":"4461_CR18","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s00270-014-0992-0","volume":"38","author":"M Li","year":"2015","unstructured":"Li M, Bai M, Qi X, Li K, Yin Z, Wang J, et al. Percutaneous transhepatic biliary metal stent for malignant hilar obstruction: results and predictive factors for efficacy in 159 patients from a single center. Cardiovasc Intervent Radiol. 2015;38(3):709\u201321.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"2","key":"4461_CR19","doi-asserted-by":"publisher","first-page":"82","DOI":"10.4103\/sjg.SJG_326_17","volume":"24","author":"JX Zhang","year":"2018","unstructured":"Zhang JX, Zu QQ, Liu S, Zhou CG, Xia JG, Shi HB. Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction. Saudi J Gastroenterol. 2018;24(2):82\u20136.","journal-title":"Saudi J Gastroenterol"},{"issue":"2","key":"4461_CR20","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3348\/kjr.2000.1.2.65","volume":"1","author":"DH Lee","year":"2000","unstructured":"Lee DH, Yu JS, Hwang JC, Kim KH. Percutaneous placement of self-expandable metallic biliary stents in malignant extrahepatic strictures: indications of transpapillary and suprapapillary methods. Korean J Radiol. 2000;1(2):65\u201372.","journal-title":"Korean J Radiol"},{"issue":"10","key":"4461_CR21","first-page":"738","volume":"104","author":"YY Chiou","year":"2005","unstructured":"Chiou YY, Tseng HS, Chiang JH, Hwang JI, Chou YH, Chang CY. Percutaneous placement of metallic stents in the management of malignant biliary obstruction. J Formos Med Assoc. 2005;104(10):738\u201343.","journal-title":"J Formos Med Assoc"},{"issue":"8","key":"4461_CR22","doi-asserted-by":"publisher","first-page":"714","DOI":"10.5152\/tjg.2019.18317","volume":"30","author":"QQ Zu","year":"2019","unstructured":"Zu QQ, Zhang JX, Wang B, Ye W, Liu S, Shi HB. Percutaneous transpapillary biliary stent placement for distal malignant biliary obstruction: outcomes and survival analysis. Turk J Gastroenterol. 2019;30(8):714\u201321.","journal-title":"Turk J Gastroenterol"},{"issue":"5","key":"4461_CR23","doi-asserted-by":"publisher","first-page":"806","DOI":"10.5009\/gnl220437","volume":"17","author":"SY Han","year":"2023","unstructured":"Han SY, Lee TH, Jang SI, Kim DU, Yang JK, Cho JH, et al. Efficacy analysis of suprapapillary versus transpapillary self-expandable metal stents according to the level of obstruction in malignant extrahepatic biliary obstruction. Gut Liver. 2023;17(5):806\u201313.","journal-title":"Gut Liver."},{"issue":"6","key":"4461_CR24","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1016\/j.gie.2005.05.015","volume":"63","author":"T Okamoto","year":"2006","unstructured":"Okamoto T, Fujioka S, Yanagisawa S, Yanaga K, Kakutani H, Tajiri H, et al. Placement of a metallic stent across the main duodenal papilla may predispose to cholangitis. Gastrointest Endosc. 2006;63(6):792\u20136.","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"4461_CR25","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.gie.2008.12.054","volume":"70","author":"SP Misra","year":"2009","unstructured":"Misra SP, Dwivedi M. Reflux of duodenal contents and cholangitis in patients undergoing self-expanding metal stent placement. Gastrointest Endosc. 2009;70(2):317\u201321.","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"4461_CR26","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/den.14006","volume":"34","author":"M Kuwatani","year":"2022","unstructured":"Kuwatani M, Kawakubo K, Sakamoto N. Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting. Digest Endosc. 2022;34(2):334\u201344.","journal-title":"Digest Endosc"},{"issue":"06","key":"4461_CR27","doi-asserted-by":"publisher","first-page":"e753","DOI":"10.1055\/a-1135-8437","volume":"08","author":"R Takada","year":"2020","unstructured":"Takada R, Ikezawa K, Kiyota R, Imai T, Abe Y, Fukutake N, et al. Self-expandable metallic stent placement above the papilla without endoscopic sphincterotomy in patients with distal malignant biliary obstruction. Endosc Int Open. 2020;08(06):e753\u201360.","journal-title":"Endosc Int Open"},{"issue":"4","key":"4461_CR28","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1007\/s10620-019-05859-1","volume":"65","author":"J Shin","year":"2020","unstructured":"Shin J, Park JS, Jeong S, Lee DH. Comparison of the clinical outcomes of suprapapillary and transpapillary stent insertion in unresectable cholangiocarcinoma with biliary obstruction. Dig Dis Sci. 2020;65(4):1231\u20138.","journal-title":"Dig Dis Sci"},{"issue":"11","key":"4461_CR29","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1111\/den.14825","volume":"36","author":"H Isayama","year":"2024","unstructured":"Isayama H, Hamada T, Fujisawa T, Fukasawa M, Hara K, Irisawa A, et al. TOKYO criteria 2024 for the assessment of clinical outcomes of endoscopic biliary drainage. Digest Endosc. 2024;36(11):1195\u2013210.","journal-title":"Digest Endosc"},{"issue":"10","key":"4461_CR30","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","volume":"4","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296.","journal-title":"PLoS Med"},{"key":"4461_CR31","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s00270-025-04200-w","volume":"49","author":"D Filippiadis","year":"2026","unstructured":"Filippiadis D, Pereira PL, Hausegger KA, et al. CIRSE standards of practice for the classification of complications: the modified CIRSE classification system. Cardiovasc Intervent Radiol. 2026;49:2\u20136.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"30","key":"4461_CR32","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1055\/s-2007-1001389","volume":"17","author":"Q Liu","year":"1998","unstructured":"Liu Q, Khay G, Cotton PB. Feasibility of stent placement above the sphincter of Oddi (\u201cinside-stent\u201d) for patients with malignant biliary obstruction. Endoscopy. 1998;17(30):687\u201390.","journal-title":"Endoscopy"},{"issue":"6","key":"4461_CR33","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/S1051-0443(93)71970-3","volume":"4","author":"J Stoker","year":"1993","unstructured":"Stoker J, Lam\u00e9ris JS. Complications of percutaneously inserted biliary wallstents. J Vasc Interv Radiol. 1993;4(6):767\u201372.","journal-title":"J Vasc Interv Radiol"},{"issue":"6","key":"4461_CR34","doi-asserted-by":"publisher","first-page":"498","DOI":"10.4251\/wjgo.v8.i6.498","volume":"8","author":"BR Boulay","year":"2016","unstructured":"Boulay BR, Birg A. Malignant biliary obstruction: from palliation to treatment. World J Gastrointest Oncol. 2016;8(6):498\u2013508.","journal-title":"World J Gastrointest Oncol"},{"issue":"6","key":"4461_CR35","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1097\/MCG.0000000000000584","volume":"51","author":"N Cosgrove","year":"2017","unstructured":"Cosgrove N, Siddiqui AA, Adler DG, Shahid H, Sarkar A, Sharma A, et al. A comparison of bilateral side-by-side metal stents deployed above and across the sphincter of Oddi in the management of malignant hilar biliary obstruction. J Clin Gastroenterol. 2017;51(6):528\u201333.","journal-title":"J Clin Gastroenterol"}],"container-title":["CardioVascular and Interventional Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04461-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00270-026-04461-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04461-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:07:12Z","timestamp":1785686832000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00270-026-04461-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["4461"],"URL":"https:\/\/doi.org\/10.1007\/s00270-026-04461-z","relation":{},"ISSN":["1432-086X"],"issn-type":[{"value":"1432-086X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"18 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr Frances Sheehan is a clinical research fellow funded by the British Society of Interventional Radiology and the Royal College of Radiologists and the Circulation Foundation. These funding bodies had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript for this study.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and \/ or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study has obtained institutional review board approval and the need for informed consent was waived.","order":3,"name":"Ethics","label":"Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this type of study, consent for publication is not required.","order":4,"name":"Ethics","label":"Consent to Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}