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<article article-type="research-article" dtd-version="1.2" xml:lang="ru" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="issn">2687-0940</journal-id><journal-title-group><journal-title>Challenges in modern medicine</journal-title></journal-title-group><issn pub-type="epub">2687-0940</issn></journal-meta><article-meta><article-id pub-id-type="doi">10.52575/2687-0940-2026-49-1-39-51</article-id><article-id pub-id-type="publisher-id">276</article-id><article-categories><subj-group subj-group-type="heading"><subject>SURGERY</subject></subj-group></article-categories><title-group><article-title>&lt;strong&gt;Endobiliary Stenting of Perpapillary Tumor Obstruction Using Digital Modeling of a Coated Self-Expanding Stent&lt;/strong&gt;</article-title><trans-title-group xml:lang="en"><trans-title>&lt;strong&gt;Endobiliary Stenting of Perpapillary Tumor Obstruction Using Digital Modeling of a Coated Self-Expanding Stent&lt;/strong&gt;</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Okhotnikov</surname><given-names>Oleg I.</given-names></name><name xml:lang="en"><surname>Okhotnikov</surname><given-names>Oleg I.</given-names></name></name-alternatives><email>oleg_okhotnikov@mail.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Yakovleva</surname><given-names>Marina V.</given-names></name><name xml:lang="en"><surname>Yakovleva</surname><given-names>Marina V.</given-names></name></name-alternatives></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Okhotnikov</surname><given-names>Andrey O.</given-names></name><name xml:lang="en"><surname>Okhotnikov</surname><given-names>Andrey O.</given-names></name></name-alternatives></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Antonova</surname><given-names>Olga V.</given-names></name><name xml:lang="en"><surname>Antonova</surname><given-names>Olga V.</given-names></name></name-alternatives></contrib></contrib-group><pub-date pub-type="epub"><year>2026</year></pub-date><volume>49</volume><issue>1</issue><fpage>0</fpage><lpage>0</lpage><self-uri content-type="pdf" xlink:href="/media/journal-medicine/2026/1/АПМ_2026_Том_49__1_39-51.pdf" /><abstract xml:lang="ru"><p>Endobiliary stenting of the peripapillary tumor obstruction zone suggests the development of ascending cholangitis. Objective: To study the antireflux effect of biliary stenting as a factor in the prevention of cholangitis by forming an intraduodenal segment of a covered stent, the parameters of which are determined on the basis of a digital model. Materials and methods: Patients with peripapillary malignant neoplasm (42&amp;nbsp;control group, 23 main group) after implantation of self-expanding covered and uncovered endobiliary stents. We assessed the presence of reflux of duodenal contents into the biliary tree and the clinical picture of cholangitis, the stability of the stent position (presence of migration) and its destruction. Results: The analysis of the digital stent model showed that the optimal position is the transpapillary location of the covered self-expanding stent with an intraduodenal segment of 25&amp;ndash;30 % of the total length. Conclusion: The use of an endobiliary covered self-expanding stent with a 25&amp;ndash;30 % intraduodenal segment reduces the risk of developing reflux-associated cholangitis. At the same time, the required positional stability of the stent and its resistance to destruction are preserved.</p></abstract><trans-abstract xml:lang="en"><p>Endobiliary stenting of the peripapillary tumor obstruction zone suggests the development of ascending cholangitis. Objective: To study the antireflux effect of biliary stenting as a factor in the prevention of cholangitis by forming an intraduodenal segment of a covered stent, the parameters of which are determined on the basis of a digital model. Materials and methods: Patients with peripapillary malignant neoplasm (42&amp;nbsp;control group, 23 main group) after implantation of self-expanding covered and uncovered endobiliary stents. We assessed the presence of reflux of duodenal contents into the biliary tree and the clinical picture of cholangitis, the stability of the stent position (presence of migration) and its destruction. Results: The analysis of the digital stent model showed that the optimal position is the transpapillary location of the covered self-expanding stent with an intraduodenal segment of 25&amp;ndash;30 % of the total length. Conclusion: The use of an endobiliary covered self-expanding stent with a 25&amp;ndash;30 % intraduodenal segment reduces the risk of developing reflux-associated cholangitis. At the same time, the required positional stability of the stent and its resistance to destruction are preserved.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>antegrade endobiliary stenting</kwd><kwd>coated and non-coated self-expanding stent</kwd><kwd>reflux-associated cholangitis</kwd><kwd>tumor obstruction of the common bile duct</kwd></kwd-group><kwd-group xml:lang="en"><kwd>antegrade endobiliary stenting</kwd><kwd>coated and non-coated self-expanding stent</kwd><kwd>reflux-associated cholangitis</kwd><kwd>tumor obstruction of the common bile duct</kwd></kwd-group></article-meta></front><back><ref-list><title>Список литературы</title><ref id="B1"><mixed-citation>Bor R., F&amp;aacute;bi&amp;aacute;n A., Szűcs M., B&amp;aacute;lint A., Rutka M., T&amp;oacute;th T., Czak&amp;oacute; L., Farkas K., Buz&amp;aacute;s N., Milassin &amp;Aacute;., Moln&amp;aacute;r T., Szepes Z. 2023. 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