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

 Sung Ill Jang  ;  Jie-Hyun Kim  ;  DongKi Lee  ;  Takao Itoi  ;  Jung Whan You  ;  Hee Wook Kim  ;  Kwang Hoon Lee  ;  Jong Yoon Won 
 Gastrointestinal Endoscopy, Vol.74(5) : 1040-1048, 2011 
Journal Title
 Gastrointestinal Endoscopy 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Biochemistry & Molecular Biology (생화학-분자생물학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김지현(Kim, Ji Hyun) ; 원종윤(Won, Jong Yun) ; 유정환(You, Jung Whan) ; 이광훈(Lee, Kwang Hun) ; 이동기(Lee, Dong Ki) ; 장성일(Jang, Sung Ill)
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