THE TANNENBAUM STENT - A NEW PLASTIC BILIARY STENT WITHOUT SIDE HOLES

Objective: Clogging of plastic biliary stents used in malignant biliar y obstruction remains a major problem. In vitro studies have shown tha t side holes, a standard feature of commercially available stents, may contribute to stent clogging, In a pilot study, we designed and prosp ectively evaluated a new biliary stent without side holes (Tannenbaum stent). Methods: Over a 12-month period, 55 consecutive patients (mean age 75 yr) with malignant distal common bile duct obstruction and wit hout papillary or duodenal tumor infiltration underwent endoscopic pla cement of the Tannenbaum stent for the palliative treatment of jaundic e. Results: Tannenbaum stent insertion was technically successful on t he first attempt in all patients and was accompanied by a significant reduction in mean serum bilirubin levels (10.1-1.6 mg%). Fifty-one pat ients were followed until death (median survival of 130 days); the sym ptomatic occlusion rate was 16%, the dislocation rate was 8%, and the median stent patency was 64 wk. Aside from stent clogging, there were no complications. Conclusion: The Tannenbaum stent provided effective palliative biliary decompression in all patients. The patency rate was longer than that reported in the literature for conventional plastic stents with side holes and compared favorably with patency rates that have been reported for the metallic expandable biliary stents. The res ults of this pilot study are encouraging and warrant further studies.