Magnetic compression anastomosis for biliojejunostomy and pancreaticojejunostomy in Whipple's procedure: An initial clinical study

Abstract

Background and Aim Magnetic anastomosis has been attempted in biliary and intestinal reconstruction. The objective of the current study was to introduce an initial clinical use of magnetic compression anastomosis for pancreaticojejunostomy and biliojejunostomy in Whipple's procedure. Methods Patients with peri‐ampullary carcinoma and dilated bile and pancreatic ducts were prospectively enrolled from 2016 to 2017. After pancreaticoduodenectomy, an appropriate mother magnet and drainage tube was placed in the proximal bile duct and pancreatic duct. The daughter magnets were introduced to mate with the mother magnets at the anastomotic sites. A close postoperative surveillance and routine cholangiopancreaticography via the drainage tube were performed. Results One female and three male patients with a median age of 69 years (range, 57–77) were included. The diameter of the common bile ducts and pancreatic ducts ranged from 8 to 15 mm, and 7 to 10 mm, respectively. The median time duration for biliojejunostomy and pancreaticojejunostomy was 7 (range, 5–8 min) min and 9 (range, 8–10 min) min, respectively. The median time of biliojejunostomy and pancreaticojejunostomy formation was 17 (range, 15–21 days) days and 11 (range, 10–18 days), respectively. With a median follow up of 313 days, one patient developed biliary anastomotic stricture at 11 months after surgery, and underwent stent placement via percutaneous transhepatic drainage sinus, and recovered well. Conclusions Magnetic anastomosis is safe, effective, and simple for both biliojejunostomy and pancreaticojejunostomy in Whipple's procedure.

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Magnetic Compression Anastomosis for the Treatment of Post-Transplant Biliary Stricture

“…34 The difference in the MCA method between bilioenteric anastomosis strictures and biliobilary strictures is the route for magnet delivery. 24,34,70 The delivery route for magnets in biliobiliary strictures is mainly the percutaneous-peroral tract.…”

Establishment of Yan-Zhang's staging of digestive tract magnetic compression anastomosis in a rat model

“…MCA is currently being used for esophago-gastric anastomosis 1 , gastro-intestinal anastomosis 2 , 3 , small intestine anastomosis 4 , 5 , colonic anastomosis 6 , 7 , and rectovaginal fistula closure repair 8 . MCA has a wide range of applications and can be used during open, laparoscopic, robotic, and endoscopic operations 9 – 11 . It is the third commonly used technique of anastomosis after hand-sewn and stapled anastomosis.…”