• Wandong Hong, Shanxi Chen, Qihuai Zhu, Huichun Chen, Jingye Pan, and Qingke Huang.
• Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
• Clinics (Sao Paulo). 2014 Sep 1; 69 (9): 647-52.

ObjectiveThere is no consensus regarding the most appropriate methods (i.e., the side-by-side versus the stent-in-stent technique) for placing bilateral stents for malignant hilar biliary obstructions. We aimed to perform a quantitative review of the published data regarding the clinical efficacy of the side-by-side and stent-in-stent bilateral drainage techniques for hilar biliary obstructions.MethodsA comprehensive search of several databases was conducted and a fixed-effects or random-effects model was used to pool the data from all of the study end-points.ResultsFour clinical trials were identified. A comparison of the side-by-side and stent-in-stent groups revealed no significant differences with respect to the rates of successful placement, successful drainage, early complications, late complications and stent occlusions. There were also no significant inter-group differences in stent patency and patient survival and no publication bias was observed.ConclusionsThe performance of the side-by-side technique appears to be similar to that of the stent-in-stent technique for bilateral drainage in patients with malignant hilar biliary obstructions.

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