Magnetic compression anastomosis for treatment of biliary anastomotic stricture after orthotopic liver transplantation

Abstract

Objective To study the safety and efficacy of magnetic compression anastomosis (MCA) in treatment of biliary anastomotic stricture after orthotopic liver transplantation (LT). Methods Five patients who were treated unsuccessfully by ERCP were admitted to The First Affiliated Hospital of Xi'an Jiaotong University from 2012 January to 2018 May to undergo MCA. The treatment results were analyzed retrospectively. Results In four patients, the treatment was successful while in one patient it failed. For the four successful patients, the biliary stricture length was 2~4 mm. Re-canalization was achieved within 7~12 days and these patients were discharged home without any adverse events. Multiple plastic stents (in 2 patients) or full-covered self-expansion mental stents (in 2 patients) were inserted into the new fistulae after re-canalization. In two patients whose stents were removed, there was no recurrence of biliary strictures after follow-up for 64 months and 59 months, respectively. Conclusion The MCA technique is a revolutionary and effective method of performing interventional choledochocholedochostomy in patients with biliary anastomotic stricture after LT for whom the conventional endoscopic procedures were not successful. Key words: Magnetic compression anastomosis; Biliary anastomotic stricture; Liver transplantation