Abstract
A 68-year old man, who was diagnosed with hilar cholangiocarcinoma, had an en bloc resection of his left lobe of the liver and extrahepatic bile duct. Biliary reconstruction was performed by hepatico-jejunostomy in Roux-en Y style, with total three anastomoses to B5, B8, and posterior branch. Nineteen days after the operation, an abscess formation was found around hepatico-jejunostomy due to a leakage from the anastomosis of B5 branch. In order to recover from this issue, we applied the magnetic compression anastomosis. Firstly the PTBD of B5 branch was done to create an insertion route for a guidewire of the magnet, attached to the tip of a guidewire. Under radiographic guidance, the inserted magnet through the catheter in B5 branch was attracted to another magnet that was inserted into jejunal limb, through the walls of the intestine. Six days after the maneuver, these magnets formed a new anastomosis between B5 branch and the jejunum without any complication, resulting in a successful harvest of the magnets. Although it was needed to leave a 10 Fr-sized catheter in the new anastomosis of B5 for three months, we have not experienced anastomotic stenosis or cholangitis in this case for six months after the treatment.
