{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T06:54:15Z","timestamp":1775112855662,"version":"3.50.1"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100015792","name":"Government of Pudong New Area","doi-asserted-by":"publisher","award":["No. 2025-PWXZ-04"],"award-info":[{"award-number":["No. 2025-PWXZ-04"]}],"id":[{"id":"10.13039\/100015792","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["PWZxq2022-06"],"award-info":[{"award-number":["PWZxq2022-06"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Endoscopic placement of fully covered self-expanding metal stents (FCSEMS) is a treatment for distal biliary strictures (DBS). However, there remains a notable gap in the research regarding the efficacy and safety of FCSEMS in benign distal biliary stricture (BDBS) and malignant distal biliary stricture (MDBS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare the short-term efficacy and long-term safety of FCSEMS in benign versus malignant DBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective, single-center cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of 123 patients with DBS who underwent FCSEMS placement via endoscopic retrograde cholangiopancreatography (ERCP) at Shanghai East Hospital Affiliated to Tongji University from January 2019 to December 2024. Patients were stratified into BDBS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200946) and MDBS (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200977) based on comprehensive diagnostic criteria, including medical history (underlying diseases, prior surgeries, etc.), clinical manifestations, laboratory tests (hepatic function panel, tumor biomarkers, IgG4, autoimmune antibodies, etc.), and multimodality imaging (Computed Tomography, magnetic resonance cholangiopancreatography, endoscopic ultrasound, etc.). The primary endpoint was short-term stricture resolution rate; secondary endpoints included ERCP-related complication rates (short- and long-term).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Median follow-up durations were comparable between BDBS (6 (4,9)\u2009months) and MDBS (7 (4,12)\u2009months) groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Short-term stricture resolution rates were 97.8% (45\/46) in the BDBS group and 92.2% (71\/77) in the MDBS group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Early ERCP complications (hyperamylasemia, bleeding, perforation, cholecystitis) did not differ significantly between groups (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). However, the incidence of post-ERCP pancreatitis (PEP) was markedly higher in BDBS (37.0%, 17\/46) than in MDBS (7.8%, 6\/77;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Long-term complications (stent migration, occlusion) showed no intergroup differences (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05), but late biliary infections were more frequent in MDBS (41.7%, 10\/24) versus BDBS (7.7%, 3\/39;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>FCSEMS effectively alleviates strictures in both benign and malignant DBS, with comparable short-term efficacy. Notably, BDBS patients had a higher risk of early PEP, whereas MDBS patients were more prone to late biliary infections. Long-term stricture resolution was not analyzed due to divergent disease trajectories (e.g., limited survival in MDBS).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261435331","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T11:06:25Z","timestamp":1774868785000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative study on the application of fully covered self-expanding metal stents in benign and malignant strictures of the distal bile duct"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5272-2092","authenticated-orcid":false,"given":"Ziyan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, P.R. 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5876-0745","authenticated-orcid":false,"given":"Xinyan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Pudong New District, Shanghai 200120, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7118-1193","authenticated-orcid":false,"given":"Feng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Pudong New District, Shanghai 200120, P.R. 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Therapeutic effect of fully covered self-expandable metal stents on benign biliary stricture. Chin J Dig Endosc 2017; 34(7): 461\u2013465.","journal-title":"Chin J Dig Endosc"},{"issue":"11","key":"e_1_3_4_20_2","first-page":"772","article-title":"Chinese guidelines for ERCP (2018)","volume":"57","author":"ERCP Group, Chinese Society of Digestive Endoscopology; Biliopancreatic Group, Chinese Association of Gastroenterologist and Hepatologist; National Clinical Research Center for Digestive Diseases","year":"2018","unstructured":"ERCP Group, Chinese Society of Digestive Endoscopology; Biliopancreatic Group, Chinese Association of Gastroenterologist and Hepatologist; National Clinical Research Center for Digestive Diseases. Chinese guidelines for ERCP (2018). 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