Endoscopy · 2025
Long-term follow-up results after the recanalization of completely obstructed benign biliary strictures using magnetic compression anastomosis.
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Jang Sung Ill, Lee See Young, Jang Sunguk, Cho Jae Hee, Jo Jung Hyun, Jung Chan Min, Lee Hye Sun, Jeon Soyoung, Lee Kwang-Hun, Joo Seung-Moon, Yum Tae Jun, Lee Dong Ki
Аннотация
BACKGROUND: Benign biliary stricture (BBS) often responds to conventional nonsurgical approaches but remains challenging if obstruction is complete. Magnetic compression anastomosis (MCA) has emerged as a nonsurgical alternative.
METHODS: MCA was performed in patients with completely obstructed BBS unresponsive to endoscopic or percutaneous techniques. One magnet was inserted through a percutaneous transhepatic biliary drainage pathway, while the other was advanced through an alternative route. After magnet approximation and recanalization, an internal catheter or fully covered self-expandable metal stent (FCSEMS) was placed across the newly formed tract for about 6 months. Patients were followed for a median of 75.2 months to assess complications and BBS recurrence.
RESULTS: Of 113 patients who underwent MCA, technical success was achieved in 106 (93.8%) and clinical success in 105 (92.9%). One patient developed mild MCA-related cholangitis, which improved with conservative management. No MCA-related mortality or other major complications occurred. During follow-up, 14.3% had recurrence at a median of 23.7 months (range 3.3-64.9) after catheter or stent removal. No patients required surgical intervention during the study period. All recurrences were treated with repeat MCA or FCSEMS placement.
CONCLUSION: MCA was an effective nonsurgical treatment option for patients with completely occluded BBS refractory to standard interventions, and demonstrated a low recurrence rate in long-term follow-up.
METHODS: MCA was performed in patients with completely obstructed BBS unresponsive to endoscopic or percutaneous techniques. One magnet was inserted through a percutaneous transhepatic biliary drainage pathway, while the other was advanced through an alternative route. After magnet approximation and recanalization, an internal catheter or fully covered self-expandable metal stent (FCSEMS) was placed across the newly formed tract for about 6 months. Patients were followed for a median of 75.2 months to assess complications and BBS recurrence.
RESULTS: Of 113 patients who underwent MCA, technical success was achieved in 106 (93.8%) and clinical success in 105 (92.9%). One patient developed mild MCA-related cholangitis, which improved with conservative management. No MCA-related mortality or other major complications occurred. During follow-up, 14.3% had recurrence at a median of 23.7 months (range 3.3-64.9) after catheter or stent removal. No patients required surgical intervention during the study period. All recurrences were treated with repeat MCA or FCSEMS placement.
CONCLUSION: MCA was an effective nonsurgical treatment option for patients with completely occluded BBS refractory to standard interventions, and demonstrated a low recurrence rate in long-term follow-up.