Magnetic compression anastomosis for the stricture of the choledochocholedochostomy after ABO-incompatible living donor liver transplantation

Akira Umemura, Akira Sasaki, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Go Wakabayashi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Biliary complications, such as stricture or obstruction after living donor liver transplantation (LDLT), are still major problems. Magnetic compression anastomosis (MCA) is a minimally invasive and nonsurgical procedure in patients with biliary structure or obstruction. A 49-year-old woman who had had ABO-incompatible LDLT 16 months previously presented with obstructive jaundice. After sufficient improvement of obstructive jaundice by percutaneous transhepatic cholangiodrainage (PTCD), the rendezvous technique between PTCD and endoscopic retrograde cholangiopancreatography was attempted in order to break through the stricture, but this was not successful. Therefore, MCA was performed. A parent magnet was endoscopically placed at the common bile duct side of the stricture, and the daughter magnet, attached to a guidewire, was also inserted to the intrahepatic bile duct. Both magnets were advanced to positions immediately prior to the biliary obstruction, and it was confirmed that the two magnets attracted each other magnetically, sandwiching the stricture. Twenty-four days after MCA, as recanalization could be achieved without any adverse events, the magnets were removed via the PTCD fistula. MCA enabled us to create a fistula without complications. In conclusion, when a conventional endoscopic or percutaneous approach, including the rendezvous technique, has failed, MCA is a novel method for patients with the stricture of the choledochocholedochostomy after LDLT.

Original languageEnglish
Pages (from-to)361-364
Number of pages4
JournalClinical journal of gastroenterology
Volume7
Issue number4
DOIs
Publication statusPublished - 2014 Aug
Externally publishedYes

Keywords

  • Biliary tract stenosis
  • Choledochocholedochostomy
  • Liver transplantation
  • Magnetic compression anastomosis

ASJC Scopus subject areas

  • Gastroenterology

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