Long-term follow-up results after the recanalization of completely obstructed benign biliary strictures using magnetic compression anastomosis

Background: Benign biliary stricture (BBS) often responds to conventional nonsurgical approaches but remain challenging in complete obstruction. Magnetic compression anastomosis (MCA) has emerged as a nonsurgical alternative. Methods: MCA was performed in patients with completely obstructed BBS unresponsive to endoscopic or percutaneous techniques. One magnet was inserted through a percutaneous transhepatic biliary drainage pathway, while the other was advanced through an alternative route. After magnet approximation and recanalization, an internal catheter or fully covered self-expandable metal stent (FCSEMS) was placed across the newly formed tract for about six months. Patients were followed for a median of 75.2 months to assess complications and BBS recurrence. Results: Of the 113 patients who underwent MCA, 106 experienced recanalization. One patient developed mild MCA-related cholangitis, which improved with conservative management. No MCA-related mortality or other major complications occurred. During follow-up, 14.3% had recurrence at a median of 23.7 months (3.3–64.9 months) after catheter or stent removal. Overall success was 92.9%. No patients required surgical intervention during the study period. All recurrences were treated with repeat MCA or FCSEMS insertion. Conclusion: MCA is an effective nonsurgical treatment option for patients with completely occluded BBS refractory to standard interventions, demonstrating a low recurrence rate in long-term follow-up.

Publication History

Received: 13 February 2025

Accepted after revision: 24 October 2025

Accepted Manuscript online:
24 October 2025