{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:20:37Z","timestamp":1782843637787,"version":"3.54.5"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Economic Development and Innovation Operational Programme Grant","award":["GINOP-2.3.2-15-2016-00048"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00048"]}]},{"name":"Economic Development and Innovation Operational Programme Grant","award":["GINOP-2.3.4-15-2020-00010"],"award-info":[{"award-number":["GINOP-2.3.4-15-2020-00010"]}]},{"name":"Economic Development and Innovation Operational Programme Grant","award":["EFOP-3.6.1.-16-2016-00004"],"award-info":[{"award-number":["EFOP-3.6.1.-16-2016-00004"]}]},{"name":"Human Resources Development Operational Programme Grant","award":["GINOP-2.3.2-15-2016-00048"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00048"]}]},{"name":"Human Resources Development Operational Programme Grant","award":["GINOP-2.3.4-15-2020-00010"],"award-info":[{"award-number":["GINOP-2.3.4-15-2020-00010"]}]},{"name":"Human Resources Development Operational Programme Grant","award":["EFOP-3.6.1.-16-2016-00004"],"award-info":[{"award-number":["EFOP-3.6.1.-16-2016-00004"]}]},{"name":"European Social Fund","award":["GINOP-2.3.2-15-2016-00048"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00048"]}]},{"name":"European Social Fund","award":["GINOP-2.3.4-15-2020-00010"],"award-info":[{"award-number":["GINOP-2.3.4-15-2020-00010"]}]},{"name":"European Social Fund","award":["EFOP-3.6.1.-16-2016-00004"],"award-info":[{"award-number":["EFOP-3.6.1.-16-2016-00004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and study aims: Endoscopic biliary stent placement is a minimally invasive intervention for patients with biliary strictures. Stent patency and function time are crucial factors. Suprapapillary versus transpapillary stent positioning may contribute to stent function time, so a meta-analysis was performed in this comparison. Methods: A comprehensive literature search was conducted in the CENTRAL, Embase, and MEDLINE databases to find data on suprapapillary stent placement compared to the transpapillary method via endoscopic retrograde cholangiopancreatography in cases of biliary stenosis of any etiology and any stent type until December 2020. We carried out a meta-analysis focusing on the following outcomes: stent patency, stent migration, rate of cholangitis and pancreatitis, and other reported complications. Results: Three prospective and ten retrospective studies involving 1028 patients were included. Suprapapillary stent placement appeared to be superior to transpapillary stent positioning in patency (weighted mean difference = 50.23 days, 95% CI: 8.56, 91.98; p = 0.0.018). In a subgroup analysis of malignant indications, suprapapillary positioning showed a lower rate of cholangitis (OR: 0.34, 95% CI: 0.13, 0.93; p = 0.036). Another subgroup analysis investigating metal stents in a suprapapillary position resulted in a lower rate of pancreatitis (OR: 0.16, 95% CI: 0.03, 0.95; p = 0.043) compared to transpapillary stent placement. There was no difference in stent migration rates between the two groups (OR: 0.67, 95% CI: 0.17, 2.72; p = 0.577). Conclusions: Based on our results, suprapapillary biliary stenting has longer stent patency. Moreover, the stent migration rate did not differ between the suprapapillary and transpapillary groups.<\/jats:p>","DOI":"10.3390\/jcm12030898","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:50:41Z","timestamp":1674449441000},"page":"898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Suprapapillary Biliary Stents Have Longer Patency Times than Transpapillary Stents\u2014A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8532-5191","authenticated-orcid":false,"given":"Norbert","family":"Kov\u00e1cs","sequence":"first","affiliation":[{"name":"Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary"},{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0499-6004","authenticated-orcid":false,"given":"D\u00e1niel","family":"P\u00e9csi","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Division of Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Sipos","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelli","family":"Farkas","sequence":"additional","affiliation":[{"name":"Institute of Bioanalysis, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1ria","family":"F\u00f6ldi","sequence":"additional","affiliation":[{"name":"Doctoral School of Clinical Medicine, University of Szeged, 6720 Szeged, Hungary"},{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Heim P\u00e1l National Pediatric Institute, 1089 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"},{"name":"Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Bajor","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1lint","family":"Er\u0151ss","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2213-4865","authenticated-orcid":false,"given":"Katalin","family":"M\u00e1rta","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Mik\u00f3","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Department of Medical Genetics, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1499-3416","authenticated-orcid":false,"suffix":"Jr.","given":"Zolt\u00e1n","family":"Rakonczay","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Sarl\u00f3s","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szabolcs","family":"\u00c1brah\u00e1m","sequence":"additional","affiliation":[{"name":"Department of Surgery, Szent-Gy\u00f6rgyi Albert Medical and Pharmaceutical Centre, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-7686","authenticated-orcid":false,"given":"\u00c1ron","family":"Vincze","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1055\/s-0043-109865","article-title":"Efficacy of self-expandable metal stents in management of benign biliary strictures and comparison with multiple plastic stents: A meta-analysis","volume":"49","author":"Khan","year":"2017","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1038\/ajg.2016.512","article-title":"Plastic vs. Self-Expandable Metal Stents for Palliation in Malignant Biliary Obstruction: A Series of Meta-Analyses","volume":"112","author":"Almadi","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e753","DOI":"10.1055\/a-1135-8437","article-title":"Self-expandable metallic stent placement above the papilla without endoscopic sphincterotomy in patients with distal malignant biliary obstruction","volume":"8","author":"Takada","year":"2020","journal-title":"Endosc. Int. Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4253\/wjge.v10.i1.16","article-title":"New 14-mm diameter Niti-S biliary uncovered metal stent for unresectable distal biliary malignant obstruction","volume":"10","author":"Kikuyama","year":"2018","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3109\/00365529209011171","article-title":"Experimental clogging of biliary endoprostheses. Role of bacteria, endoprosthesis material, and design","volume":"27","author":"Dowidar","year":"1992","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0016-5107(85)72004-4","article-title":"Endoscopic biliary prostheses: A comparison of materials","volume":"31","author":"Leung","year":"1985","journal-title":"Gastrointest. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1055\/s-2005-870131","article-title":"Mechanisms of biliary stent clogging: Confocal laser scanning and scanning electron microscopy","volume":"37","author":"Groen","year":"2005","journal-title":"Endoscopy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s00535-004-1535-2","article-title":"Estimation of the stent placement above the intact sphincter of Oddi against malignant bile duct obstruction","volume":"40","author":"Uchida","year":"2005","journal-title":"J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/den.14006","article-title":"Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting","volume":"34","author":"Kuwatani","year":"2021","journal-title":"Dig. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.gie.2017.08.024","article-title":"Association of covered metallic stents with cholecystitis and stent migration in malignant biliary stricture","volume":"87","author":"Jang","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0016-5107(99)70353-6","article-title":"Retrieval of distally migrated, impacted biliary endoprostheses using a novel guidewire\/basket \"lasso\" technique","volume":"50","author":"Mergener","year":"1999","journal-title":"Gastrointest. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/S0016-5107(98)70038-0","article-title":"Randomized trial of stent placed above and across the sphincter of Oddi in malignant bile duct obstruction","volume":"48","author":"Pedersen","year":"1998","journal-title":"Gastrointest. Endosc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2020","journal-title":"Res. Synth. Methods"},{"key":"ref_17","unstructured":"Sch\u00fcnemann, H.B.J., Guyatt, G., and Oxman, A. (2013). GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations, The GRADE Working Group. Available online: guidelinedevelopment.org\/handbook."},{"key":"ref_18","unstructured":"(2020). GRADEpro GDT: GRADEpro Guideline Development Tool, McMaster University. Available online: gradepro.org."},{"key":"ref_19","unstructured":"Higgins, J.P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2021). Cochrane Handbook for Systematic Reviews of Interventions, Cochrane. Available online: www.training.cochrane.org\/handbook."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control. Clin. Trials"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"261","DOI":"10.3102\/10769986030003261","article-title":"Bias and Efficiency of Meta-Analytic Variance Estimators in the Random-Effects Model","volume":"30","author":"Viechtbauer","year":"2005","journal-title":"J. Educ. Behav. Stat."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"64","DOI":"10.7178\/jig.192","article-title":"Transpapillary vs. intraductal fully covered selfexpanding metal stent placement for malignant and benign biliary disease: Does it make a difference?","volume":"5","author":"Brijbassie","year":"2015","journal-title":"J. Interv. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1097\/MCG.0000000000000584","article-title":"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","volume":"51","author":"Cosgrove","year":"2017","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Inatomi, O., Bamba, S., Shioya, M., Mochizuki, Y., Ban, H., Tsujikawa, T., Saito, Y., Andoh, A., and Fujiyama, Y. (2013). Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction. BMC Gastroenterol., 13.","DOI":"10.1186\/1471-230X-13-31"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kobayashi, N., Watanabe, S., Hosono, K., Kubota, K., Nakajima, A., Kaneko, T., Sugimori, K., Tokuhisa, M., Goto, A., and Mori, R. (2015). Endoscopic inside stent placement is suitable as a bridging treatment for preoperative biliary tract cancer. BMC Gastroenterol., 15.","DOI":"10.1186\/s12876-015-0233-2"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E427","DOI":"10.1055\/s-0042-102246","article-title":"Stent placement above the sphincter of Oddi permits implementation of neoadjuvant chemotherapy in patients with initially unresectable Klatskin tumor","volume":"4","author":"Kubota","year":"2016","journal-title":"Endosc. Int. Open"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1007\/s10620-019-05859-1","article-title":"Comparison of the Clinical Outcomes of Suprapapillary and Transpapillary Stent Insertion in Unresectable Cholangiocarcinoma with Biliary Obstruction","volume":"65","author":"Shin","year":"2020","journal-title":"Dig. Dis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"AB139","DOI":"10.1016\/j.gie.2013.04.049","article-title":"Prospective randomized trial comparing covered metal stent placed above and across the sphincter of oddi in malignant biliary obstruction","volume":"77","author":"Cho","year":"2013","journal-title":"Gastrointest. Endosc."},{"key":"ref_29","first-page":"44","article-title":"Modified Fully Covered Self-Expandable Metal Stent Versus Plastic Stent For Preoperative Biliary Drainage In Patients With Resectable Malignant Biliary Obstruction","volume":"50","author":"Lee","year":"2018","journal-title":"Endoscopy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.gie.2020.03.2219","article-title":"Intraductal vs. transpapillary fully covered metal stent placement for malignant biliary strictures","volume":"91","author":"Taniguchi","year":"2020","journal-title":"Gastrointest. Endosc."},{"key":"ref_31","first-page":"175","article-title":"Intraductal Plastic Stent Placement is an Effective Therapy for Unresectable Malignant Hilar Biliary Obstruction","volume":"34","author":"Yamaguchi","year":"2019","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (minors): Development and validation of a new instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/den.12078","article-title":"Biliary self-expandable metallic stent for unresectable malignant distal biliary obstruction: Which is better: Covered or uncovered?","volume":"25","author":"Isayama","year":"2013","journal-title":"Dig. Endosc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1093\/jac\/dkz128","article-title":"Novel antimicrobial coatings based on polylactide for plastic biliary stents to prevent post-endoscopic retrograde cholangiography cholangitis","volume":"74","author":"Obermeier","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/den.13679","article-title":"Antireflux metal stent for biliary obstruction: Any benefits?","volume":"33","author":"Hamada","year":"2021","journal-title":"Dig. Endosc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1055\/s-2007-1010294","article-title":"A prospective, randomized, controlled trial of metal stents for malignant obstruction of the common bile duct","volume":"25","author":"Knyrim","year":"1993","journal-title":"Endoscopy"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1007\/s00464-010-0931-3","article-title":"Outcome of second interventions for occluded metallic stents in patients with malignant biliary obstruction","volume":"24","author":"Ridtitid","year":"2010","journal-title":"Surg. Endosc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/S0016-5107(00)70149-0","article-title":"Are biliary stents placed above the sphincter of oddi really ineffective?","volume":"51","author":"Matsushita","year":"2000","journal-title":"Gastrointest. Endosc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1055\/s-0043-125062","article-title":"Covered vs. uncovered self-expandable metal stents for malignant distal biliary strictures: A systematic review and meta-analysis","volume":"50","author":"Tringali","year":"2018","journal-title":"Endoscopy"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.gie.2005.05.015","article-title":"Placement of a metallic stent across the main duodenal papilla may predispose to cholangitis","volume":"63","author":"Okamoto","year":"2006","journal-title":"Gastrointest. Endosc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S1499-3872(12)60238-0","article-title":"Endoscopic sphincterotomy associated cholangitis in patients receiving proximal biliary self-expanding metal stents","volume":"11","author":"Zhou","year":"2012","journal-title":"Hepatobiliary Pancreat. Dis. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/den.12584","article-title":"Does endoscopic sphincterotomy reduce the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis after biliary stenting? A systematic review and meta-analysis","volume":"28","author":"Sofi","year":"2016","journal-title":"Dig. Endosc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.gie.2010.05.023","article-title":"Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents","volume":"72","author":"Kumar","year":"2010","journal-title":"Gastrointest. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/den.12071","article-title":"Necessity for endoscopic sphincterotomy for biliary stenting in cases of malignant biliary obstruction","volume":"25","author":"Okano","year":"2013","journal-title":"Dig. Endosc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/898\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:14:01Z","timestamp":1760120041000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12030898"],"URL":"https:\/\/doi.org\/10.3390\/jcm12030898","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}