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

 Sung Ill Jang  ;  Jie-Hyun Kim  ;  Jong Yoon Won  ;  Kwang Hoon Lee  ;  Hee Wook Kim  ;  Jung Whan You  ;  Takao Itoi  ;  DongKi Lee 
 GASTROINTESTINAL ENDOSCOPY, Vol.74(5) : 1040-1048, 2011 
Journal Title
Issue Date
Adult ; Anastomosis, Surgical/adverse effects ; Bile Ducts/surgery* ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Cholestasis/diagnostic imaging ; Cholestasis/etiology ; Cholestasis/therapy* ; Constriction, Pathologic/diagnostic imaging ; Constriction, Pathologic/etiology ; Constriction, Pathologic/therapy ; Female ; Humans ; Liver Transplantation/adverse effects* ; Living Donors* ; Magnets* ; Male ; Middle Aged ; Retrospective Studies ; null
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.


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.
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1. College of Medicine (의과대학) > Dept. of Biochemistry and Molecular Biology (생화학-분자생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Yu, Jung Hwan(유정환)
Lee, Kwang Hun(이광훈)
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
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