Magnetic Compression Anastomosis for the Treatment of Post-Transplant Biliary Stricture

Jang, Sung Ill; Cho, Jae Hee; Lee, Dong Ki

doi:10.5946/ce.2020.095

Cited by 28 publications

(18 citation statements)

References 69 publications

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“…Contrast series data set is used as well to reproduce angiography images to delineate tumoral vascular invasion [25]. MDCT cholangiography assesses globally the biliary obstruction regarding the biliary tree, vessels, and solid abdominal organs (liver, pancreas, and duodenum), a feature that does not exist at ERCP and PTC [29,30].…”

Section: Discussionmentioning

confidence: 99%

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Alsowey

Salem

Amin

2021

Egypt J Radiol Nucl Med

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Background MDCT cholangiography can be utilized to identify variant biliary anatomy to guide preoperative planning of biliary surgery, and determine the cause and level of biliary obstruction. Early tumor detection and staging of biliary cancer are key factors for a possible cure by surgical resection. Between December 2019 and October 2020, 69 patients with clinically suspected biliary obstruction were enrolled in the study, subjected to clinical assessment (full history taking and clinical examination) and imaging assessment by MDCT cholangiography. Our findings were correlated to standard reference examinations including operative/ERCP/biopsy and histopathology findings. Results The most affected age was between 60 and 70 years old, and males were more affected. The commonest clinical presentation was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination. Our patients were categorized according to the etiology of biliary obstruction into 7 groups: malignant stricture 52.2% (36 patients), calcular 24.6% (17 patients), iatrogenic 5.8% (4 patients), portahepatis lesions 5.8% (4 patients), benign stricture 4.3% (3 patients), inflammatory 4.3% (3 patients), and congenital 1.4% (1 patient). The malignant group shows dominant mass, moderate biliary obstruction, and arterial and venous enhancement. The overall sensitivity was 94% for malignancy. Conclusion MDCT cholangiography is non-invasive, fast, and highly sensitive and specific in the diagnosis of different causes and levels of biliary obstruction and is useful in the characterization of the lesion in cases of malignant obstruction and differentiating it from benign stricture. It can be used as an effective alternative to ERCP or PTC.

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Section: Discussionmentioning

confidence: 99%

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Alsowey

Salem

Amin

2021

Egypt J Radiol Nucl Med

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“…for accurate evaluation of the length of the stricture for successful approximation of magnets before MCA. The overall clinical success rate of MCA for duct-toduct biliary strictures was reported to be 87.5%, and the recurrence rate was 7.1% [7]. The clinical success rates of MCA differ according to the etiology of the stricture and the treatment method used in duct-to-duct biliary strictures [26][27][28][29][30].…”

Section: Annals Of Liver Transplantation Annals Of Liver Transplantationmentioning

confidence: 99%

“…Magnetic compression anastomosis (MCA) has been used as a nonsurgical technique for reconstructing a refractory or completely obstructing BBS that cannot be resolved with conventional methods [7][8][9][10][11][12][13][14][15]. MCA entails recanalizing the obstructed bile duct by inserting magnets at both ends of the stenosis, inducing necrosis of the stenotic lesion based on the pulling force of magnets.…”

Section: Introductionmentioning

confidence: 99%

Magnetic compression anastomosis for treatment of post-transplant biliary stricture: A case report with dual-graft living donor liver transplantation

Jung

Park

Song

et al. 2021

Ann Liver Transplant

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“…Such patients have recently been treated via magnetic compression anastomosis. 10 A percutaneous tract is required for magnet delivery; several biliary interventions are needed to prepare and maintain a new anastomotic fistula. The treatment period is extended.…”

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confidence: 99%

Biliary Complications after Living Donor Liver Transplantation Differ from Those after Deceased Donor Liver Transplantation

Jang

Lee

2022

Gut and Liver

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Yoon et al. 1 analyzed 3,481 Korean patients who underwent liver transplantation (LT) between 2012 and 2014, followed by endoscopic and radiological biliary interventions. This paper was meaningful as it was a national survey using Korea Health Insurance Review and Assessment data. 2 However, the codes reflected only the procedures performed; the reasons, methods, and results were lacking. Also, it was unclear whether surgery featured duct-to-duct anastomosis or hepaticojejunostomy in patients undergoing living donor LT (LDLT).LT in Korea differs markedly from that in Western countries. The LDLT rate is more than 2-fold higher than that of deceased donor LT (DDLT). 3 Lee et al. 3 established right-lobe LDLT in Korea. Accordingly, in recent years, Korea has become a leading country in LDLT. In Korea's family-centered culture, this surgery has become a source of hope for end-stage liver-disease patients. However, compared to DDLT, LDLT is more difficult and is associated with a higher incidence of biliary complications. 4 Duct-toduct anastomosis is preferred to hepaticojejunostomy in LDLT for various reasons. When duct-to-duct anastomosis is performed, the bile duct anastomosis site is higher (at the hilum) than in DDLT. In LDLT, the angle between the bile duct of the new liver and the extrahepatic bile duct is acute, which is associated with risks of ischemia and traction in surrounding tissues. If the transplanted liver becomes hypertrophic, an anastomotic stricture is possible. 5-8 Also, anastomotic stricture sometimes accompanies bile leakage.Yoon et al. 1 reported that the average number of biliary interventions in LDLT patients was 3.4±2.0, of which the

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Magnetic Compression Anastomosis for the Treatment of Post-Transplant Biliary Stricture

Cited by 28 publications

References 69 publications

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction

Magnetic compression anastomosis for treatment of post-transplant biliary stricture: A case report with dual-graft living donor liver transplantation

Biliary Complications after Living Donor Liver Transplantation Differ from Those after Deceased Donor Liver Transplantation

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