Magnetic compression anastomosis for treatment of benign biliary stricture

Dig Endosc. 2015 Jan;27(2):239-49. doi: 10.1111/den.12319. Epub 2014 Oct 16.

Abstract

Endoscopic and percutaneous procedures have shown high success rates when used to treat benign biliary stricture. However, cases in which a guidewire cannot be passed through a refractory stricture or a complete obstruction are difficult to treat using conventional methods. Magnetic compression anastomosis (MCA) has emerged as a non-surgical alternative avoiding operational mortality and morbidity. The feasibility and safety of MCA have been experimentally and clinically verified in cases of biliobiliary and bilioenteric anastomosis. However, no pre-MCA assessment modality capable of predicting outcomes is as yet available, and no universally effective magnet delivery method has as yet been established, rendering it difficult to identify patients for whom MCA is appropriate. Various experimental studies seeking to overcome these limitations are underway. Such work will improve our in-depth understanding of MCA, which has been trialed in various fields. Upon further development, MCA may become a ground-breaking option for treatment of benign strictures that are difficult to resolve using conventional methods, and MCA may be expected to be minimally traumatic and highly effective. The aim of the present study was to discuss the current status of MCA and the direction of MCA development by reviewing clinical and experimental MCA data.

Keywords: anastomosis stricture; benign biliary stricture; biliary obstruction; compressive anastomosis; magnetic compression anastomosis.

Publication types

  • Review

MeSH terms

  • Anastomosis, Surgical / methods
  • Bile Ducts / surgery*
  • Cholestasis / therapy*
  • Humans
  • Intestine, Small / surgery*
  • Magnetics / instrumentation*