GIE Associate Editor Monique Barakat, MD, highlights this article from the December issue: “Magnetic compression anastomosis for the treatment of complete biliary obstruction after cholecystectomy” by Sung Ill Jang, MD, PhD, et al.

Post-cholecystectomy biliary strictures are generally managed endoscopically. However, when complete occlusion of the duct occurs, management with entirely endoscopic approaches is not possible.

This study describes and reports on outcomes of a hybrid endoscopic/interventional radiology approach of magnetic compression anastomosis for managing these challenging post-cholecystectomy strictures.

We are in an era of expansion of the repertoire of hybrid endoscopic and interventional radiology interventions. This study addresses one such approach, which is innovative and can serve as a springboard for similar hybrid approaches.

Magnetic compression anastomosis, at centers amenable to this, may serve as an alternative to biliary reconstruction surgery. Collaboration between interventional radiologists and endoscopists can be highly synergistic.

Magnetic compression anastomosis for post-cholecystectomy complete obstruction (Strasberg type B). A, A cholangiogram showed complete obstruction of the right intrahepatic duct after cholecystectomy. B, One magnet was delivered through the percutaneous transhepatic biliary drainage tract, and the other was advanced through the common bile duct. C, Magnets were approximated via 2 delivery tracts. D, After the approximated magnets were removed, the guidewire could pass the stricture site. E, A fully covered self-expandable metal stent was inserted at the recanalized site. F, After removal of the fully covered self-expandable metal stent, a cholangiogram showed complete resolution of the biliary obstruction.

Read the full article online.

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