Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation

Abstract Background Magnetic compression anastomosis (MCA) is a minimally invasive method of anastomosis that does not involve a surgical procedure in patients with stricture, obstruction, or dehiscence of anastomosis after surgery. We experienced a case of complete dehiscence of bilioenteric anasto...

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Main Authors: Masahiko Kubo, Hiroshi Wada, Hidetoshi Eguchi, Kunihito Gotoh, Yoshifumi Iwagami, Daisaku Yamada, Hirofumi Akita, Tadafumi Asaoka, Takehiro Noda, Shogo Kobayashi, Masahisa Nakamura, Yusuke Ono, Keigo Osuga, Eigoro Yamanouchi, Yuichiro Doki, Masaki Mori
Format: Article
Language:English
Published: Japan Surgical Society 2018-08-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0504-6
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author Masahiko Kubo
Hiroshi Wada
Hidetoshi Eguchi
Kunihito Gotoh
Yoshifumi Iwagami
Daisaku Yamada
Hirofumi Akita
Tadafumi Asaoka
Takehiro Noda
Shogo Kobayashi
Masahisa Nakamura
Yusuke Ono
Keigo Osuga
Eigoro Yamanouchi
Yuichiro Doki
Masaki Mori
author_facet Masahiko Kubo
Hiroshi Wada
Hidetoshi Eguchi
Kunihito Gotoh
Yoshifumi Iwagami
Daisaku Yamada
Hirofumi Akita
Tadafumi Asaoka
Takehiro Noda
Shogo Kobayashi
Masahisa Nakamura
Yusuke Ono
Keigo Osuga
Eigoro Yamanouchi
Yuichiro Doki
Masaki Mori
author_sort Masahiko Kubo
collection DOAJ
description Abstract Background Magnetic compression anastomosis (MCA) is a minimally invasive method of anastomosis that does not involve a surgical procedure in patients with stricture, obstruction, or dehiscence of anastomosis after surgery. We experienced a case of complete dehiscence of bilioenteric anastomosis that was successfully treated by MCA. Case presentation A 55-year-old woman received ABO-incompatible right-lobe living-donor liver transplantation with hepaticojejunostomy for the right anterior duct (RAD) and right posterior duct (RPD). Nineteen days after the operation, bilious and bloody discharge was detected from the abdominal drain. We performed an emergency operation and found that the anastomosis was completely dehiscent. We placed bile drainage catheters into the stumps of the RAD and RPD. She repeatedly experienced cholangitis after the surgery, so we added percutaneous transhepatic cholangial drainage (PTCD) tubes. We decided to treat the complete dehiscence of anastomosis by MCA. One year after the liver transplantation, we performed MCA for the RAD. The bilioenteric fistula was completed 21 days after MCA, and the magnets were retrieved by double-balloon endoscopy. Two months later, MCA for the RPD was also performed by the same procedure. The bilioenteric fistula was not completely established, so we performed double-balloon endoscopy and pulled the magnets down 47 days after MCA for the RAD. The internal/external bile drainage tubes were then left in place to maintain the bilioenteric fistula. Twelve months after MCA for the RAD and 19 months after MCA for the RPD, we removed the tubes without any complications. Conclusion Magnetic compression anastomosis for stricture, obstruction, or dehiscence of the anastomosis after living-donor liver transplantation was an effective and safe procedure.
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spelling doaj-art-e19f9fca5b4d4e8784545e81911b136c2025-08-20T03:39:25ZengJapan Surgical SocietySurgical Case Reports2198-77932018-08-01411810.1186/s40792-018-0504-6Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantationMasahiko Kubo0Hiroshi Wada1Hidetoshi Eguchi2Kunihito Gotoh3Yoshifumi Iwagami4Daisaku Yamada5Hirofumi Akita6Tadafumi Asaoka7Takehiro Noda8Shogo Kobayashi9Masahisa Nakamura10Yusuke Ono11Keigo Osuga12Eigoro Yamanouchi13Yuichiro Doki14Masaki Mori15Department of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Diagnostic and Interventional Radiology, Graduated School of Medicine, Osaka UniversityDepartment of Diagnostic and Interventional Radiology, Graduated School of Medicine, Osaka UniversityDepartment of Diagnostic and Interventional Radiology, Graduated School of Medicine, Osaka UniversityDepartment of Radiology, International University of Health and Welfare HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalDepartment of Gastroenterological Surgery, Graduated School of Medicine, Osaka University HospitalAbstract Background Magnetic compression anastomosis (MCA) is a minimally invasive method of anastomosis that does not involve a surgical procedure in patients with stricture, obstruction, or dehiscence of anastomosis after surgery. We experienced a case of complete dehiscence of bilioenteric anastomosis that was successfully treated by MCA. Case presentation A 55-year-old woman received ABO-incompatible right-lobe living-donor liver transplantation with hepaticojejunostomy for the right anterior duct (RAD) and right posterior duct (RPD). Nineteen days after the operation, bilious and bloody discharge was detected from the abdominal drain. We performed an emergency operation and found that the anastomosis was completely dehiscent. We placed bile drainage catheters into the stumps of the RAD and RPD. She repeatedly experienced cholangitis after the surgery, so we added percutaneous transhepatic cholangial drainage (PTCD) tubes. We decided to treat the complete dehiscence of anastomosis by MCA. One year after the liver transplantation, we performed MCA for the RAD. The bilioenteric fistula was completed 21 days after MCA, and the magnets were retrieved by double-balloon endoscopy. Two months later, MCA for the RPD was also performed by the same procedure. The bilioenteric fistula was not completely established, so we performed double-balloon endoscopy and pulled the magnets down 47 days after MCA for the RAD. The internal/external bile drainage tubes were then left in place to maintain the bilioenteric fistula. Twelve months after MCA for the RAD and 19 months after MCA for the RPD, we removed the tubes without any complications. Conclusion Magnetic compression anastomosis for stricture, obstruction, or dehiscence of the anastomosis after living-donor liver transplantation was an effective and safe procedure.http://link.springer.com/article/10.1186/s40792-018-0504-6Magnetic compression anastomosisLiving-donor liver transplantationComplete dehiscence of bilioenteric anastomosis
spellingShingle Masahiko Kubo
Hiroshi Wada
Hidetoshi Eguchi
Kunihito Gotoh
Yoshifumi Iwagami
Daisaku Yamada
Hirofumi Akita
Tadafumi Asaoka
Takehiro Noda
Shogo Kobayashi
Masahisa Nakamura
Yusuke Ono
Keigo Osuga
Eigoro Yamanouchi
Yuichiro Doki
Masaki Mori
Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
Surgical Case Reports
Magnetic compression anastomosis
Living-donor liver transplantation
Complete dehiscence of bilioenteric anastomosis
title Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
title_full Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
title_fullStr Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
title_full_unstemmed Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
title_short Magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living-donor liver transplantation
title_sort magnetic compression anastomosis for the complete dehiscence of hepaticojejunostomy in a patient after living donor liver transplantation
topic Magnetic compression anastomosis
Living-donor liver transplantation
Complete dehiscence of bilioenteric anastomosis
url http://link.springer.com/article/10.1186/s40792-018-0504-6
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