Biliary Recanalization with Magnets in a Liver Transplant Patient via Combined ERCP and EUS-guided Hepaticogastrostomy

作者：M Cobreros del Caz, A. Busatto, V Marquina Truebano, R N Isabel, J Ruiz Rodríguez, Carlos de la Serna Higuera, Ramón Sánchez-Ocaña, Manuel Pérez‐Miranda · 发表于：Endoscopy · 年份：2025 · DOI：10.1055/s-0045-1806657 · 研究领域：Pediatric Hepatobiliary Diseases and Treatments、Gallbladder and Bile Duct Disorders、Organ Transplantation Techniques and Outcomes

Text Anastomotic strictures after liver transplantation are typically managed by ERCP, but guidewire passage failure poses challenges. We present the case of a 60-year-old man with a complete bile duct cut-off at the choledocho-choledochostomy. Transpapillary cholangioscopy failed to traverse the stricture. Subsequently, EUS-hepaticogastrostomy (HGS) was performed with a fully-covered SEMS, followed by the insertion of two magnets via anterograde and retrograde routes. Fluoroscopic imaging confirmed their alignment. After two weeks, the magnets were retrieved transpapillary, confirming fistula creation. The stricture was dilated, and a covered metal stent was placed transpapillary, with removal of the previously placed transgastric covered SEMS. In conclusion, endoscopic magnetic compression anastomosis via EUS-guided hepaticogastrostomy in lieu of PTBD can be considered in severe anastomotic strictures post-liver transplantation. Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/e0911baa-cd63-48c0-9a40-c05a2c33c826/Uploads/16849_Imanes_TOH_ESGE.mp4 Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany