Abstract
Clogging of biliary endoprosthesis has been a persistent problem faced by endoscopists
over many years. Evidence suggests that incorporating sideholes increases the risk
of plastic stents clogging. We conducted a prospective, nonrandomized study comparing
10 Fr Teflon pigtail (PT) stents with sideholes to a new design 10 Fr Teflon straight
stent without sideholes, designated as the “Tannenbaum” (TB) stent. Seventy-four consecutive
patients were treated with the PT stent and 55 consecutive patients with the TB stent
in two different periods. All patients had malignant distal biliary obstruction with
jaundice. Stent insertion was successful in all patients, and a significant reduction
in serum bilirubin levels was achieved. All follow-up patients, except one in the
TB group, had died at the time of reporting. Median survival in the PT group was 100
days (range: 6-636 days) and 130 days (range: 3-703 days) in the TB group. Median
follow-up in the PT group was 104 days (range: 6-636 days) and 141 days (range: 3-537
days) in the TB group. Statistical analysis shows significantly longer patency for
the TB stent (p < 0.02). Moreover, the results of the TB stent compared favorably
with the published results of metallic self-exapandable biliary stents. We believe
the TB stent holds great promise for the future of endoscopic biliary stenting. Prospective
randomized studies comparing the TB stent with existing plastic and metal stents are,
however, necessary.
