{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:52:41Z","timestamp":1782989561171,"version":"3.54.5"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100008048","name":"nanjing university","doi-asserted-by":"publisher","award":["2022-YXZX-XH-02"],"award-info":[{"award-number":["2022-YXZX-XH-02"]}],"id":[{"id":"10.13039\/501100008048","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Project of Chinese Hospital Reform and Development Institute, Nanjing University","award":["NDYG2022032"],"award-info":[{"award-number":["NDYG2022032"]}]},{"name":"Nanjing Drum Tower Hospital Health Education And Research Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Gastroenterol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is no consensus on the optimal endoscopic drainage strategy for hilar malignant biliary obstruction (HMBO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare transpapillary plastic stent (PS) plus endoscopic nasobiliary drainage (ENBD) with PSs alone for HMBO, and to evaluate risk factors for cholangitis in the combined strategy group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 175 consecutive patients with HMBO (Bismuth type II\u2013IV) who underwent either PS plus ENBD or PSs alone were enrolled. Propensity score matching (1:1) was performed to reduce selection bias. The primary endpoint was successful drainage. Univariate analysis was used to identify risk factors for cholangitis in the PS plus ENBD group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After matching, 74 patients remained in each group, with balanced baseline characteristics. Successful drainage rates were 77.0% in the PS plus ENBD group and 68.9% in the PSs alone group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.267). The PSs alone group had significantly higher rates of cholangitis (23.0% vs 10.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.048) and overall adverse events (29.7% vs 12.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.009). No significant differences were observed in biliary patency, reintervention, or survival time between groups. In the PS plus ENBD group, initial drainage was associated with cholangitis (100.0% vs 59.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.011), and median drainage volume was lower in patients who developed cholangitis (85\u2009mL vs 250\u2009mL,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.021). In 19 patients, the nasobiliary catheter was snipped to convert external to internal drainage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Endoscopic biliary stenting combined with ENBD followed by catheter snipping is a safe and effective approach for HMBO. The addition of ENBD was associated with reduced rates of cholangitis and overall adverse events. In this combined strategy, lack of initial drainage and low drainage volume were associated with cholangitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26317745261457315","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:50:58Z","timestamp":1782712258000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic biliary stenting combined with nasobiliary drainage in hilar malignant biliary obstruction"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0280-4769","authenticated-orcid":false,"given":"Yonghua","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongliang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, SuiXi County Hospital of Traditional Chinese Medicine, Huaibei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Zhao","sequence":"additional","affiliation":[{"name":"A Unit of the Paramilitary Police in Nanjing, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojiao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoliang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12128"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(02)70003-5"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000528"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/den.13549"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/den.12700"},{"key":"e_1_3_4_7_2","article-title":"Step-wise endoscopic approach to palliative bilateral biliary drainage for unresectable advanced malignant hilar obstruction","volume":"9","author":"Choi JH","year":"2019","unstructured":"Choi JH, Lee SH, You MS, et al. Step-wise endoscopic approach to palliative bilateral biliary drainage for unresectable advanced malignant hilar obstruction. 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Conversion from external nasobiliary drainage to internal drainage using endoscopically available scissor forceps. 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