ENDOSCOPIC REPAIR OF POST-SURGICAL DISCONNECTED BILE DUCTS (DBDS) BY MAGNETIC COMPRESSION ANASTOMOSIS (MCA) VIA EUS-GUIDED ANASTOMOSES

Daughter/parent magnets were placed into proximal/distal sides of DBDs<15-mm apart. A 5x8-mm daughter-magnet was placed via EUS-guided SEMS hepaticogastrostomy in two patients. A same-sized parent-magnet was placed by ERCP into the distal biliary stump of a post-cholecystectomy Strasberg-E3 transection patient with hepatolithiasis and native GI-anatomy. A 4x10-mm double-disc parent-magnet was placed via EUS-guided LAMS gastrojejunostomy on the jejunum of a Roux-en-Y post-Whipple patient. Both magnet sets coupled within 10-days. Transpapillary/trans-anastomotic SEMS were placed across the MCA upon magnet/transhepatic SEMS removal, and retrieved 4/8 months later, respectively. Cholangioscopy documented DBD reconnection. Both patients remain symptom and stent free at 2/9 months.

Publication History

Article published online:
14 April 2022