{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:47:38Z","timestamp":1778672858009,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic management of unresectable hilar malignant biliary obstruction (HMBO) is technically challenging, and effectiveness of stent\u2010in\u2010stent using large\u2010cell, metal stents was reported. A new, large\u2010cell stent with a 6F tapered delivery system was recently developed. The aim of this study was to compare clinical outcomes of slim\u2010delivery and conventional large\u2010cell stents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter retrospective comparative study of stent\u2010in\u2010stent methods using slim\u2010delivery stents (Niti\u2010S Large Cell SR Slim Delivery [LC slim\u2010delivery]) and conventional stents (Niti\u2010S large\u2010cell D\u2010type; LCD) for unresectable HMBO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010three patients with HMBO were included; 31 LC slim\u2010delivery and 52 LCD. Overall technical and clinical success rates were 100% and 90% in LC slim\u2010delivery group and 98% and 88% in LCD group. Use of the LC slim\u2010delivery was associated with shorter stent placement time in the multiple regression analysis, with a stent placement time of 18 and 23\u2009min in LC slim\u2010delivery and LCD groups, respectively. The early adverse event (AE) rate of LC slim\u2010delivery was 10%, with no cholangitis or cholecystitis as compared to 23% in the LCD group. Recurrent biliary obstruction (RBO) rates and time to RBO were comparable between the two groups: 35% and 44%, and 8.5 and 8.0\u2009months in LC slim\u2010delivery and LCD groups, respectively. The major cause of RBO was tumor ingrowth (82%) in the LC slim\u2010delivery group and sludge (43%) and ingrowth (48%) in LCD group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Stent\u2010in\u2010stent methods using LC slim\u2010delivery shortened stent placement time with low early AE rates and comparable time to RBO in patients with HMBO.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14604","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T18:59:50Z","timestamp":1685473190000},"page":"360-369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Retrospective comparative study of new slim\u2010delivery and conventional large\u2010cell stents for stent\u2010in\u2010stent methods for hilar malignant biliary obstruction"],"prefix":"10.1111","volume":"36","author":[{"given":"Kazunaga","family":"Ishigaki","sequence":"first","affiliation":[{"name":"Department 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