Magnetic Compression Anastomosis after Living-Donor-Related Liver Transplantation for Patients with a Disconnected Bile Duct: Preliminary Research
Bildiriler > Tam Metin Bildiri
Yazarlar: Mahmut Kusbeci, Halil Bozkaya, EGEMEN ÖZTÜRK, Kamil Dogan, Galip ERSÖZ, Mustafa Parildar, İlker TURAN, Abdullah Zeki KARASU
The Arab Journal of Interventional Radiology, , , Uluslararası, Tam Metin Bildiri
Özet
Background: The purpose of this study is to present the use of the magnetic compression anastomosis (MCA) technique for the treatment of disconnected bile ducts following living-donor-related liver transplantation (LDLT) with the recently introduced through-the-scope magnet. Materials and Methods: The MCA technique was used in patients who had a disconnected bile duct and were unable to be treated with percutaneous or endoscopic procedures. Before the procedure, all patients had a percutaneous external biliary drainage catheter. By pushing a 5-Fr catheter over a guidewire, the magnet was percutaneously inserted into the proximal side of the obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic papillary sphincterotomy was performed concurrently. With a 5-Fr catheter and a guidewire, the sister magnet was carefully advanced to the opposite side of the obstruction. After confirming biliary recanalization, a guidewire was passed through the stricture, and the stricture was percutaneously dilated with a balloon-tipped catheter. During the first ERCP session, the stricture was dilated with an endoscopic balloon, two plastic stents were inserted, and the internal drainage catheter was removed. Stent exchange and multiple side-by-side stent placements were scheduled at 3-month intervals for all patients. Result: Between April 2014 and November 2020, 12 LDLT patients with disconnected bile ducts (aged 36–65, six men) underwent the MCA technique. The magnet placement procedure resulted in biliary recanalization 13 to 42 days later. The procedure had a 90% success rate. Conclusions: The inclusion of a small number of patients and the lack of long-term data were the study's limitations. The current case series, on the other hand, demonstrates that the MCA technique, which employs a small magnet with a 2.4-mm diameter, is effective and useful in LDLT patients with a disconnected bile duct. Furthermore, we believe that using this small magnet makes the MCA technique simpler and less complex than using magnets with larger diameters. Publication History Article published online: 17 August 2022 © 2022. The Pan Arab Interventional Radiology Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India