Magnetic compression anastomosis for the treatment of benign biliary strictures: a clinical study from China

Liu, Yu; Sun, Haiyan; Yan, Xiaopeng; Wang, Shanpei; Dong, Dinghui; Liu, Xuemin; Wang, Bo; Su, Maosheng; Lv, Yi

doi:10.1007/s00464-019-07063-8

Cited by 31 publications

(28 citation statements)

References 26 publications

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“…The clinical success rates of MCA differ according to the etiology of the stricture and the treatment method in biliobiliary strictures. [41][42][43][44][45] Although surgery-related strictures and strictures due to stones have high resolution rates with endoscopic treatment, idiopathic and chronic pancreatitis-related strictures respond poorly to endoscopic management. 46 The clinical success rate of endoscopic treatment for biliobiliary strictures is 90% in postoperative strictures but only 65% in strictures due to chronic pancreatitis.…”

Section: Results Of Mca In Biliobiliary Strictures Post-living-donor mentioning

confidence: 99%

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

2020

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A number of different conditions can lead to a bile duct stricture. These strictures are particularly common after biliary operations, including living-donor liver transplantation. Endoscopic and percutaneous methods have high success rates in treating benign biliary strictures. However, these conventional methods are difficult to manage when a guidewire cannot be passed through areas of severe stenosis or complete obstruction. Magnetic compression anastomosis has emerged as an alternative nonsurgical treatment method to avoid the mortality and morbidity risks of reoperation. The feasibility and safety of magnetic compression anastomosis have been reported in several experimental and clinical studies in patients with biliobiliary and bilioenteric strictures. Magnetic compression anastomosis is a minimally traumatic and highly effective procedure, and represents a new paradigm for benign biliary strictures that are difficult to treat with conventional methods.

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Section: Results Of Mca In Biliobiliary Strictures Post-living-donor mentioning

confidence: 99%

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

2020

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“…In cases of failed ERC, PTCD approach is considered as alternative therapy. These methods are effective in most patients, but may fail in some special cases [16][17].…”

Section: Discussionmentioning

confidence: 99%

One-step Percutaneous Transhepatic Cholangioscopy Combined With High-frequency Needle-knife Electrotomy in Biliary Strictures After Liver Transplantation

Tao

Wang

Sun

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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BackgroundEndoscopic management is the mainstay for biliary strictures after liver transplantation. However, this method is often failed in cases associated with hepatolithiasis or refractory strictures. The aim of this study is to investigate whether one-step PTC combined with high-frequency needle-knife electrotomy can be an alternative method in biliary strictures after liver transplantation that could not be treated by endoscopic management. MethodsClinical data of 14 patients suffering from biliary strictures after liver transplantation from June 2014 to January 2018 were retrospectively analyzed. One-step PTC combined with high-frequency needle-knife electrotomy was used to resolve the strictures. ResultsOne-step PTC was successfully performed in all 14 patients. In 10 of 12 (83.3%) patients with hepatolithiasis, the stones were removed completely. The stricture resolution was achieved in 13 of 14 (92.9%) patients at supporting catheter removal. Three mild adverse events occurred (cholangitis, 2 patient; delayed hemobilia, 1 patient), but were resolved with conservative treatment. The follow up after supporting catheter removal was 15.7 ± 4.5 months. Only 1 patient (8.3%) had stone recurrence and no stenosis occurred during supporting-free follow-up. ConclusionOne-step PTC combined with high-frequency needle-knife electrotomy appears to be a useful for treating biliary strictures after liver transplantation.

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“…The daughter magnet was delivered via the preoperative biliary drainage route to the proximal end of the obstruction, and the parent magnet was delivered via endoscopic retrograde cholangiopancreatography to the distal end of the obstruction. After recanalization, the magnetic compression anastomosis device was removed, and biliary stenting was performed for at least 6 months with complete resolution of the condition [29,30]. Additionally, 2 patients with bile leakage detected at the telemedicine follow-up management were admitted immediately for endoscopic retrograde cholangiopancreatography and a biliary stent implanted under the guidance of transplant specialists.…”

Section: Major Complications After Liver Transplantationmentioning

confidence: 99%

Telemedicine for Follow-up Management of Patients After Liver Transplantation: Cohort Study

Tian¹,

Wang²,

Xue³

et al. 2021

JMIR Med Inform

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Background Technical capabilities for performing liver transplantation have developed rapidly; however, the lack of available livers has prompted the utilization of edge donor grafts, including those donated after circulatory death, older donors, and hepatic steatosis, thereby rendering it difficult to define optimal clinical outcomes. Objective We aimed to investigate the efficacy of telemedicine for follow-up management after liver transplantation. Methods To determine the efficacy of telemedicine for follow-up after liver transplantation, we performed a clinical observation cohort study to evaluate the rate of recovery, readmission rate within 30 days after discharge, mortality, and morbidity. Patients (n=110) who underwent liver transplantation (with livers from organ donation after citizen's death) were randomly assigned to receive either telemedicine-based follow-up management for 2 weeks in addition to the usual care or usual care follow-up only. Patients in the telemedicine group were given a robot free-of-charge for 2 weeks of follow-up. Using the robot, patients interacted daily, for approximately 20 minutes, with transplant specialists who assessed respiratory rate, electrocardiogram, blood pressure, oxygen saturation, and blood glucose level; asked patients about immunosuppressant medication use, diet, sleep, gastrointestinal function, exercise, and T-tube drainage; and recommended rehabilitation exercises. Results No differences were detected between patients in the telemedicine group (n=52) and those in the usual care group (n=50) regarding age (P=.17), the model for end-stage liver disease score (MELD, P=.14), operation time (P=.51), blood loss (P=.07), and transfusion volume (P=.13). The length and expenses of the initial hospitalization (P=.03 and P=.049) were lower in the telemedicine group than they were in the usual care follow-up group. The number of patients with MELD score ≥30 before liver transplantation was greater in the usual care follow-up group than that in the telemedicine group. Furthermore, the readmission rate within 30 days after discharge was markedly lower in the telemedicine group than in the usual care follow-up group (P=.02). The postoperative survival rates at 12 months in the telemedicine group and the usual care follow-up group were 94.2% and 90.0% (P=.65), respectively. Warning signs of complications were detected early and treated in time in the telemedicine group. Furthermore, no significant difference was detected in the long-term visit cumulative survival rate between the two groups (P=.50). Conclusions Rapid recovery and markedly lower readmission rates within 30 days after discharge were evident for telemedicine follow-up management of patients post–liver transplantation, which might be due to high-efficiency in perioperative and follow-up management. Moreover, telemedicine follow-up management promotes the self-management and medication adherence, which improves patients’ health-related quality of life and facilitates achieving optimal clinical outcomes in post–liver transplantation.

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Magnetic compression anastomosis for the treatment of benign biliary strictures: a clinical study from China

Cited by 31 publications

References 26 publications

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

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

One-step Percutaneous Transhepatic Cholangioscopy Combined With High-frequency Needle-knife Electrotomy in Biliary Strictures After Liver Transplantation

Telemedicine for Follow-up Management of Patients After Liver Transplantation: Cohort Study

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