Background : Non-surgical methods have demonstrated high success rates in treating benign biliary stricture (BBS). However, conventional methods are ineffective for completely obstructed BBS. Magnetic Compression Anastomosis (MCA) has been introduced for completely obstructed BBS, demonstrating significant therapeutic effects. In this study, we evaluated the long-term outcomes of patients who underwent MCA.

Methods : MCA was performed on patients with BBS that could not be resolved using conventional endoscopic or percutaneous methods. One magnet was delivered through the percutaneous transhepatic biliary drainage tract, and the other advanced through one of the other three tracts. After magnet approximation and recanalization, an internal drainage catheter or fully covered self-expandable metal stent (FCSEMS) was maintained for 6 months with exchanges every 3 months. After the removal of the catheter and FCSEMS, patients were followed to evaluate the restenosis of BBS.

Results : Recanalization was successful in 101 out of 108 patients who underwent MCA. The MCA-related complication was mild cholangitis in one patient, treatable with conservative care. There was no mortality related to the procedure or MCA. After the removal of the catheter and FCSEMS, the mean follow-up period was 68.8 months (range: 3.3-161.1 months), and the recurrence rate of BBS during this period was 15%. The duration between catheter removal and recurrence was 23.7 months (range: 3.3-64.9 months), and re-MCA or recanalization in these patients was successful using a guidewire via the percutaneous and endoscopic tracts.

Conclusions : MCA is an alternative non-surgical recanalization method for totally obstructed BBS that cannot be treated by conventional methods. In the long-term, the rate of stricture recurrence after MCA was acceptable, and recanalization was possible.