Endoscopy 2014; 46(01): 70-74
DOI: 10.1055/s-0033-1358907
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Recanalization of refractory benign biliary stricture using magnetic compression anastomosis

Sung Ill Jang
1   Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Kwangwon Rhee
1   Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Haewon Kim
1   Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Yong Hoon Kim
1   Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Jieun Yun
2   Department of Bioevaluation Center, Korea Research Institute of Bioscience and Biotechnology, Cheongwon, Korea
,
Kwang-Hun Lee
3   Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Seungmin Bang
4   Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Jae Bok Chung
4   Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
,
Dong Ki Lee
1   Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted: 13 June 2013

accepted after revision: 10 September 2013

Publication Date:
19 November 2013 (online)

Background and study aims: Endoscopic or percutaneous treatments are preferentially attempted for benign biliary stricture (BBS). However, these methods are not feasible if a guide wire cannot be passed through the stricture. This study evaluated the usefulness and technical requirements of magnetic compression anastomosis (MCA) in refractory BBS. 

Patients and methods: MCA was performed in patients with BBS that had not been resolved with conventional treatments. One magnet was delivered through the percutaneous transhepatic biliary drainage tract and the other magnet was advanced through three different routes. After magnet approximation and recanalization, an internal drainage catheter was placed for 6 months and then removed.

Results: Seven patients underwent MCA, and recanalization was successfully achieved in five. MCA failure in two cases was attributed to long stenotic segments and parallel alignment of the axes of the magnets. The mean follow-up period after recanalization was 485.2 days. Five patients with successful recanalization showed no MCA-related complications or restenosis.

Conclusions: MCA represents an alternative nonsurgical method of BBS recanalization that cannot be treated with conventional methods.

 
  • References

  • 1 Laasch HU, Martin DF. Management of benign biliary strictures. Cardiovasc Intervent Radiol 2002; 25: 457-466
  • 2 Shimada H, Endo I, Shimada K et al. The current diagnosis and treatment of benign biliary stricture. Surg Today 2012; 42: 1143-1153
  • 3 Born P, Rosch T, Bruhl K et al. Long-term results of endoscopic and percutaneous transhepatic treatment of benign biliary strictures. Endoscopy 1999; 31: 725-731
  • 4 Huibregtse K, Katon RM, Tytgat GN. Endoscopic treatment of postoperative biliary strictures. Endoscopy 1986; 18: 133-137
  • 5 Yamanouchi EKH, Endo I et al. A new interventional method of anastomosis with magnets: magentic compression anastomosis in five clinical cases [abstract]. Cardiovasc Intervent Radiol 1998; 21: S155
  • 6 Jang SI, Kim JH, Won JY et al. Magnetic compression anastomosis is useful in biliary anastomotic strictures after living donor liver transplantation. Gastrointest Endosc 2011; 74: 1040-1048
  • 7 Rhee KW, Park CI, Jang SI et al. A case of magnetic compression anastomosis in benign ischemic biliary stricture from hepatic artery embolization to control hemorrhage due to liver laceration. Korean J Pancreas Biliary Tract 2013; 18: 14-19
  • 8 Lim HC, Lee DK, Choi HK et al. Magnet compression anastomosis for bilioenteric anastomotic stricture after removal of a choledochal cyst: a case report. Korean J Gastrointest Endosc 2010; 41: 180-184
  • 9 Cope C. Evaluation of compression cholecystogastric and cholecystojejunal anastomoses in swine after peroral and surgical introduction of magnets. J Vasc Intervent Radiol 1995; 6: 546-552
  • 10 Gonzales KD, Douglas G, Pichakron KO et al. Magnamosis III: delivery of a magnetic compression anastomosis device using minimally invasive endoscopic techniques. J Pediatr Surg 2012; 47: 1291-1295
  • 11 Itoi T, Kasuya K, Sofuni A et al. Magnetic compression anastomosis for biliary obstruction: review and experience at Tokyo Medical University Hospital. J Hepatobiliary Pancreat Sci 2011; 18: 357-365
  • 12 Suyama K, Takamori H, Yamanouchi E et al. Recanalization of obstructed choledochojejunostomy using the magnet compression anastomosis technique. Am J Gastroenterol 2010; 105: 230-231
  • 13 Itoi T, Yamanouchi E, Ikeda T et al. Magnetic compression anastomosis: a novel technique for canalization of severe hilar bile duct strictures. Endoscopy 2005; 37: 1248-1251
  • 14 Takao S, Matsuo Y, Shinchi H et al. Magnetic compression anastomosis for benign obstruction of the common bile duct. Endoscopy 2001; 33: 988-990
  • 15 Avaliani M, Chigogidze N, Nechipai A et al. Magnetic compression biliary-enteric anastomosis for palliation of obstructive jaundice: initial clinical results. J Vasc Interv Radiol 2009; 20: 614-623