Successful Reconstruction of Post-Hepatectomy Bile Duct Injury Using Magnetic Compression Anastomosis: A Case Report

Worarit Cheawchansin; Thawatchai  Tullavardhana; Sarun Mahasupachai; Wannakorn Prapasajchavet; Panitpong Maroongroge; Vasin Rungruangwuddikrai; Thana Boonsinsukh

Authors

Worarit Cheawchansin Department of Surgery, Faculty of Medicine, Srinakharinwirot University
Thawatchai Tullavardhana Department of Surgery, Faculty of Medicine, Srinakharinwirot University
Sarun Mahasupachai Department of Surgery, Faculty of Medicine, Srinakharinwirot University
Wannakorn Prapasajchavet Department of Surgery, Faculty of Medicine, Srinakharinwirot University
Panitpong Maroongroge Department of Radiology, Faculty of Medicine, Srinakharinwirot University
Vasin Rungruangwuddikrai Department of Radiology, Faculty of Medicine, Srinakharinwirot University
Thana Boonsinsukh Department of Surgery, Faculty of Medicine, Srinakharinwirot University

Keywords:

biliary stricture, bile duct injury, endoscopy, magnetic compression anastomosis

Abstract

Iatrogenic bile duct injuries (BDI) following hepatectomy represent a serious and potentially life-threatening complication. Magnetic compression anastomosis (MCA) is an emerging minimally invasive technique that can restore biliary continuity when conventional endoscopic or percutaneous methods fail. We report the case of a 68-year-old man with a history of sigmoid colon cancer and liver metastases underwent right hepatectomy with wedge resection of segment 4a. Postoperatively, he developed persistent jaundice. Imaging demonstrated left intrahepatic duct dilatation with abrupt narrowing at the hepatic confluence. Percutaneous transhepatic biliary drainage (PTBD) was established; however, guidewire cannulation via both ERCP and PTBD failed due to complete biliary obstruction. The patient subsequently underwent MCA. The magnets approximated across the stenosis, creating a neo-anastomosis. After successful biliary recanalization and stenting were achieved. At the six-month follow-up, the patient remained clinically stable with normal liver function. In conclusion, this case demonstrates the feasibility and clinical success of MCA for biliary reconstruction following iatrogenic bile duct injury post-hepatectomy. MCA offers a safe, effective, and less invasive alternative to surgical reconstruction.

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