Magnetic compression anastomosis: a novel technique for canalization of severe hilar bile duct strictures.

This report describes a successful choledochocholedochostomy using magnetic compression anastomosis in a patient with severe hilar bile duct stricture, in whom previous attempts at canalization via conventional endoscopic and percutaneous transhepatic routes had failed. An endoscope was used to position a magnet at the superior end of the hilar biliary stricture and another magnet at the inferior end. These magnets had been introduced via the percutaneous transhepatic biliary drainage (PTBD) route and via the papilla of Vater, respectively. After this procedure, two guide wires were passed easily through the segment in which the magnets adhered to one another, using a percutaneous transhepatic cholangioscope, to reach the lower common bile duct. It was then possible to place two PTBD tubes across the hilar bile duct stricture. There were no procedure-related complications.