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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 
Citation
 Gastrointestinal Endoscopy, Vol.74(5) : 1040~1048, 2011 
Journal Title
 Gastrointestinal Endoscopy 
ISSN
 0016-5107 
Issue Date
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://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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Link
 http://www.sciencedirect.com/science/article/pii/S0016510711018657
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