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Magnetic compression anastomosis is useful in biliary anastomotic strictures after living donor liver transplantation

Title
Magnetic compression anastomosis is useful in biliary anastomotic strictures after living donor liver transplantation
Authors
Sung Ill Jang;Jie-Hyun Kim;DongKi Lee;Takao Itoi;Jung Whan You;Hee Wook Kim;Kwang Hoon Lee;Jong Yoon Won
Issue Date
2011
Journal Title
Gastrointestinal Endoscopy
ISSN
0016-5107
Citation
Gastrointestinal Endoscopy, Vol.74(5) : 1040~1048, 2011
Abstract
BACKGROUND: An anastomotic biliary stricture is a complication of living donor liver transplantation (LDLT) performed using duct-to-duct anastomosis. Despite advances in treating this complication, there is no one established treatment protocol. OBJECTIVE: To investigate the safety, effectiveness, and mid-term outcome of magnetic compression anastomosis (MCA) for treating biliary obstruction after LDLT when the obstruction cannot be resolved by using percutaneous or peroral methods. DESIGN: Retrospective, observational study with standardized treatment and follow-up. SETTING: Tertiary-care academic medical center. PATIENTS: Twelve patients underwent MCA procedures to treat anastomosis site stricture after LDLT. INTERVENTIONS: MCA. MAIN OUTCOME MEASUREMENTS: Bile duct patency, technique performance, and complications were evaluated. RESULTS: We achieved magnet approximation at the anastomotic stricture in 10 of 12 patients (83.3%). The magnets failed to approximate in 2 patients. We achieved recanalization of the stricture site in 10 of 10 patients. We removed an internal catheter in 9 patients. The mean interval from magnet approximation to removal was 74.2 days (range 14-181 days). The mean time from recanalization to removal of the internal catheter was 183 days (range 51-266 days). Patients were examined regularly after removing the internal catheter with a mean follow-up period of 331 days (range 148-581 days). The observed MCA-related complications consisted of 1 case of mild cholangitis and 1 recurrence of the anastomotic stricture. LIMITATIONS: Nonrandomized study design. CONCLUSIONS: MCA safely and effectively resolved post-LDLT biliary duct-to-duct anastomotic strictures that could not be resolved using conventional methods, such as ERCP and percutaneous transhepatic biliary drainage.
URI
http://www.sciencedirect.com/science/article/pii/S0016510711018657

http://ir.ymlib.yonsei.ac.kr/handle/22282913/94435
DOI
10.1016/j.gie.2011.06.026
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Biochemistry & Molecular Biology
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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