Original Articles
“Tannenbaum” Teflon stents versus traditional polyethylene stents for treatment of malignant biliary stricture

https://doi.org/10.1067/mge.2002.121879Get rights and content

Abstract

Background: Premature stent clogging is the major limitation with plastic stents used in the treatment of malignant biliary structures. A pilot study suggested improved duration of patency of the Tannenbaum stent compared with polyethylene stents. The aim of this prospective, multicenter randomized trial was to compare the Tannenbaum Teflon stent with a conventional polyethylene endoprosthesis (Cotton-Leung biliary stent set) for the treatment of malignant biliary strictures. Methods: Patients over age 18 years with symptoms caused by nonhilar malignant biliary strictures were enrolled. Patients were randomized to receive a 10F Tannenbaum or polyethylene stent after a guidewire was passed beyond the stricture. One hundred six patients (mean age 72 years and 71 years, respectively) were enrolled (54 Tannenbaum, mean age 72 years; 52 polyethylene, mean age 71 years). Results: Tannenbaum and polyethylene stent placement was successful in, respectively, 100% and 96% of procedures without complications. The mean (SD) 90-day stent patency of the Tannenbaum stent was 67% (7%) compared with 73% (7%) for the polyethylene stents. Conclusions: The present study demonstrated no difference in ease of implantation or stent patency between Tannenbaum and polyethylene stents. (Gastrointest Endosc 2002;55:354-8.)

Section snippets

Patients and methods

Between March 1996 and June 1997, 106 patients with malignant strictures were randomly assigned by a central data coordinating center to placement of the TAN stent (Wilson-Cook Medical, Inc.), n = 54, or the Cotton-Leung stent, n = 52. Institutional review board approval was obtained at each participating institution before initiation of the study. Patients with suspected or documented malignant biliary strictures at least 1 cm distal to the hilum and not involving the papilla were eligible for

Results

One hundred six patients were enrolled at 17 participating institutions over a period of 15 months. At the various institutions the number of patients enrolled ranged from 1 to 15. Of the 106 patients, 54 were randomized to a TAN stent and 52 to PE stent.

Discussion

The majority of patients who present with malignant biliary strictures have advanced disease and are incurable by surgical resection. Endoscopic stent placement effectively bypasses the obstructed bile duct in these patients. This prospective, randomized multicenter study evaluated the safety, ease of implantation, and duration of patency of the TAN stent compared with the PE stent. Both stents performed equally well with regard to ease of implantation, stent-related complications, and

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