Post-cholecystectomy total bile duct strictures: Cases for magnetic compression anastomosis

Freddy Pereira Graterol; Francisco Salazar Marcano; Yajaira Venales Barrios; Yeisson Rivero-Moreno; Dong Ki Lee

doi:10.14701/ahbps.24-186

Ann Hepatobiliary Pancreat Surg

Published online December 23, 2024; https://doi.org/10.14701/ahbps.24-186

Freddy Pereira Graterol¹, Francisco Salazar Marcano¹, Yajaira Venales Barrios¹, Yeisson Rivero-Moreno², Dong Ki Lee³

¹Minimal Access Surgical Unit, Dr. Luís Razetti University Hospital, Barcelona, Venezuela, ²University of Oriente, Barcelona, Venezuela, ³Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Correspondence to: Freddy Pereira Graterol, MD
Minimal Access Surgical Unit, Dr. Luís Razetti University Hospital, Vía alterna, Barcelona 6001 Venezuela
Tel: +58-4166138797, Fax: +58-2812813489, E-mail: freddypereiragraterol@gmail.com
ORCID: https://orcid.org/0000-0002-9339-0567

Received September 26, 2024; Revised November 13, 2024; Accepted November 23, 2024.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract: Bile duct injuries are a serious issue, and their surgical treatment carries the risk of morbidity and mortality. In selected cases, non-surgical treatments are possible, even for total strictures. We outline the technique and results of using magnetic compression anastomosis (MCA) to treat post-cholecystectomy bile duct stricture (PCBDS), in two female patients. Initially, a bilio-cutaneous tract was established via external biliary drainage, followed by the positioning of both endoscopic and percutaneous biliary magnets. After their approximation and subsequent removal, a fully covered self-expandable metal stent (FCSEMS) was deployed across the stricture. The magnet coupling was successfully achieved within the first two weeks of placement. The FCSEMS was maintained for durations of 12 and 16 months. Follow-up durations were 28 and 15 months post-FCSEMS removal. Both patients remain asymptomatic, with normal laboratory and imaging studies, and no adverse events were reported. MCA proves to be a safe and effective method for treating selected cases of total PCBDS. However, further studies and long-term follow-up are required to fully assess the efficacy of this technique.; Keywords : Biliary tract; Bile ducts; Stricture; Magnetics