{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:15:03Z","timestamp":1776903303117,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"3-4","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":93,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Hilar\u2010type intrahepatic cholangiocarcinoma (H\u2010ICC), which originates from the large bile ducts, tends to invade the hepatic hilus and results in malignant hilar biliary obstruction (MHBO). Compared with hilar cholangiocarcinoma (HC), H\u2010ICC exhibits a more aggressive biological behavior and a dismal prognosis. We aimed to investigate the optimal biliary stenting strategy for the treatment of unresectable H\u2010ICC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with unresectable H\u2010ICC who received endoscopic biliary stenting (EBS) between January 2012 and June 2019 were retrospectively included in this study. The prognostic factors of survival outcome, clinical success, duration of stent patency, and EBS\u2010related adverse events were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether 70 patients were enrolled, including 72.9% patients with multiple intrahepatic lesions and 44.3% with lymphatic metastasis. Jaundice control was achieved in 81.4% of the patients. Early cholangitis was the main treatment\u2010related complication (17.1%). After successful stenting, systematic antitumor therapy was the only independent factor related to overall survival (hazard ratio [HR] 0.381, 95% confidence interval [CI] 0.218\u20130.668, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Plastic stenting was associated with clinical success (odds ratio [OR] 0.012, 95% CI 0.008\u20130.549, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), stent patency (HR 6.773, 95% CI 2.221\u201320.653, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and early cholangitis (OR 5.000, 95% CI 1.006\u201324.841, <jats:italic>p<\/jats:italic>\u2009=\u20090.049). Bismuth classification IV was independently related to stent patency (HR 4.956, 95% CI 1.245\u201319.730, <jats:italic>p<\/jats:italic>\u2009=\u20090.023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For H\u2010ICC\u2010induced MHBO, metal stent placement may achieve better biliary drainage and, combined with systemic antitumor therapies, may further improve patient survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13350","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T05:58:33Z","timestamp":1748930313000},"page":"170-178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Biliary Stenting Strategy for the Unresectable Hilar Type of Intrahepatic Cholangiocarcinoma: A Single\u2010Center Experience"],"prefix":"10.1111","volume":"26","author":[{"given":"Cui","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1445-376X","authenticated-orcid":false,"given":"Wen Chao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Faculty of Hepato\u2010Pancreato\u2010Biliary Surgery Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming Xing","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia Hui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting Ting","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi Yuan","family":"Yao","sequence":"additional","affiliation":[{"name":"Faculty of Hepato\u2010Pancreato\u2010Biliary Surgery Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-9083","authenticated-orcid":false,"given":"Bing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital Naval Military Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn.2018.03.16"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-04966-4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31802b34b6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-018-1469-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-011-1730-4"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.06.014"},{"key":"e_1_2_7_8_1","volume-title":"TNM Classification of Malignant Tumours (UICC)","author":"Brierley J. 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