Totally obstructed biliary stricture II: Clinical applications and results of magnetic compression anastomosis

Endoscopic and percutaneous methods have high success rates for the treatment of benign biliary stricture. However, patients in whom a guidewire cannot be passed through a refractory stricture or a complete obstruction are difficult to treat using conventional methods. Magnetic compression anastomosis (MCA) has emerged as a non-surgical alternative method to avoid the risks of mortality and morbidity associated with re-operation. The feasibility and safety of MCA have been verified experimentally and clinically in patients with biliobiliary and bilioenteric anastomoses. However, no pre-MCA assessment modality predictive of the outcomes is yet available, nor is a universally effective method of magnet delivery, which hampers identification of patients for whom MCA is available. Various experimental and human studies aiming to overcome these limitations are underway. Such works will improve our understanding of MCA, which has been trialed in various medical fields. Upon further development, MCA may be expected to be minimally traumatic and highly effective and may become a new-paradigm method for the treatment of benign strictures that are difficult to resolve using conventional methods.