1Mahmut Kusbeci, 1 Halil Bozkaya, 1 Halil Bozkaya, 1 Egemen Öztürk, 1Kamil Doğan, 2Kamil Doğan, 2Galip Ersoz, 1Mustafa Parildar, 2Ilker Turan, 2Zeki Karasu
1Department of Radiology, Ege University Medical School, 2Department of Gastroenterology, Ege University Medical School
AdeThe purpose of this study is to present the use of the magnetic compression anastomosis (MCA) technique for the treatment of disconnected bile ducts following living-donor-related liver transplantation (LDLT) with the recently introduced through-the-scope magnet
Material(s) and Method(s):
The MCA technique was used in patients who had a disconnected bile duct and were unable to be treated with percutaneous or endoscopic procedures. Before the procedure, all patients had a percutaneous external biliary drainage catheter. By pushing a 5-Fr catheter over a guidewire, the magnet was percutaneously inserted into the proximal side of the obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic papillary sphincterotomy was performed concurrently. With a 5-Fr catheter and a guidewire, the sister magnet was carefully advanced to the opposite side of the obstruction. After confirming biliary recanalization, a guidewire was passed through the stricture, and the stricture was percutaneously dilated with a balloon-tipped catheter. During the first ERCP session, the stricture was dilated with an endoscopic balloon, two plastic stents were inserted, and the internal drainage catheter was removed. Stent exchange and multiple side-by-side stent placements were scheduled at three-month intervals for all patients.
Between April 2014 and November 2020, twelve LDLT patients with disconnected bile ducts (aged 36–65, six men) underwent the MCA technique. The magnet placement procedure resulted in biliary recanalization 13–42 days later. The procedure had a 90 percent success rate.
OIn FEVAR the mode of visceral stent failures varies. Their complications and reinterventions are common and unpredictable, therefore a close surveillance must be contThe inclusion of a small number of patients and the lack of long-term data were the study’s limitations. The current case series, on the other hand, demonstrates that the MCA technique, which employs a small magnet with a 2.4-mm diameter, is effective and useful in LDLT patients with a disconnected bile duct. Furthermore, we believe that using this small magnet makes the MCA technique simpler and less complex than using magnets with larger diameters.