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Magnetic Compression Anastomosis Is a Good Treatment Option for Patients with Completely Obstructed Benign Biliary Strictures: A Case Series Study

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Abstract

Background

Completely obstructed benign biliary strictures (BBS) is a difficult-to-treat condition. Surgery is the main treatment modality with high morbidity and mortality. Recently, the magnetic compression anastomosis (MCA) technique was employed in such cases with low complication rates.

Aims

To evaluate the effectiveness of the MCA in completely obstructed BBS.

Methods

21 MCA procedures were performed in 19 patients with completely obstructed BBS. All patients had percutaneous biliary access. Magnets were located to the proximal side of the obstruction via percutaneous biliary sheath and the distal side endoscopically. The procedure was terminated as the magnets attracted. Either self-expandable fully covered metallic stent and/or a growing number of plastic stents were introduced after recanalization was achieved.

Result

A total number of 19 patients with completely obstructed BBS resulting from cholecystectomy or liver transplant underwent 21 MCA procedures. Among those, 19 (90.5%) interventions were successful. The median stricture length that had been measured after magnet attraction was 4 mm (range 1–10 mm). The median magnet coupling time in successful cases was 9 days (range 4–27 days). No correlation was found between magnet coupling time and stricture length (p = 0.27). Complications were observed in 6 (cholangitis:1, magnet migration:2, magnet entrapment:3) of 19 successful MCA procedures. Fifteen of the 19 successful procedures had at least a period of stent-free follow-up. Recurrence of stenosis occurred in 7 procedures, of which 4 remained stent-free with retreatment. Eventually, 12 procedures had stent-free last status.

Conclusions

MCA is an effective and safe treatment option in completely obstructed BBS. Further studies are required for procedural standardization.

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Acknowledgments

We would like to thank our precious experienced ERCP nurses Meftune Koçer and Esme Küçük for their hard work during the procedures.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Ankara City Hospital, Bilkent Avenue Çankaya, 06800, Ankara, Turkey

    Bülent Ödemiş & Batuhan Başpınar

  2. Department of Radiology, Division of Interventional Radiology, Ankara City Hospital, Bilkent Avenue Çankaya, 06800, Ankara, Turkey

    Muharrem Tola

  3. Faculty of Medicine, Department of Gastroenterology, Düzce University, Konuralp Campus, Beçiyörükler District, 81010, Merkez, Düzce, Turkey

    Serkan Torun

Authors
  1. Bülent Ödemiş
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  2. Batuhan Başpınar
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Correspondence to Bülent Ödemiş.

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Drs Bülent Ödemiş, Batuhan Başpınar, Muharrem Tola and Serkan Torun have no conflicts of interest or financial ties to disclose.

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Ödemiş, B., Başpınar, B., Tola, M. et al. Magnetic Compression Anastomosis Is a Good Treatment Option for Patients with Completely Obstructed Benign Biliary Strictures: A Case Series Study. Dig Dis Sci 67, 4906–4918 (2022). https://doi.org/10.1007/s10620-022-07381-3

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  • DOI: https://doi.org/10.1007/s10620-022-07381-3

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