title: Magnetic compression anastomosis is useful in biliary anastomotic strictures after living donor liver transplantation.
abstract: 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.
  
  
  METHODS
  Retrospective, observational study with standardized treatment and follow-up.
  
  
  METHODS
  Tertiary-care academic medical center.
  
  
  METHODS
  Twelve patients underwent MCA procedures to treat anastomosis site stricture after LDLT.
  
  
  METHODS
  MCA.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. DKLee@yuhs.ac
authors.forename: Sung Ill
authors.initials: SI
authors.lastname: Jang
authors.forename: Jie-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Jong Yoon
authors.initials: JY
authors.lastname: Won
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: Hee Wook
authors.initials: HW
authors.lastname: Kim
authors.forename: Jung Whan
authors.initials: JW
authors.lastname: You
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: DongKi
authors.initials: D
authors.lastname: Lee
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001652:Bile Ducts / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D059346:Magnets; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies