A CASE OF POSTSURGICAL OBSTRUCTION OF THE COMMON BILE DUCT TREATED WITH MAGNETIC COMPRESSION ANASTOMOSIS (MCA)

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A 61-year-old woman had undergone laparotomy for severe acute pancreatitis. Twelve months after the surgery, obstructive jaundice developed. Endoscopic retrograde cholangiography and percutaneous transhepatic cholangioscopy showed complete obstruction of the common bile duct. An attempt was made to pass a guidewire, but it was unsuccessful. A choledochostomy was attempted with magnetic compression anastomosis (MCA). At 22 days after the procedure, the guidewire was able to pass through alongside the magnets. The magnets were pulled out via the percutaneous transhepatic biliary drainage (PTBD) route, and a 12Fr PTBD catheter was left in place for 6 months. During a follow up period of 20 months, no recurrence of bile duct stenosis has occurred. We suggest MCA as an useful option for the management of postsurgical bile duct obstruction.