Fig. 4. Cholangiogram showing the performance of magnetic compression anastomosis using three magnets. (A) After living-donor liver transplantation, a completely obstructed anastomotic stricture occurred, and a percutaneous transhepatic biliary drain (PTBD) was inserted. (B) One magnet (diameter × length: 4 mm × 8 mm) was moved through the PTBD tract and a second magnet (2 mm × 6 mm) was moved to the common bile duct (CBD), but the approximation failed. (C) One magnet (4 mm × 8 mm) was moved through the PTBD tract and the other magnet (4 mm × 8 mm) was moved to the CBD, but the approximation again failed. (D) Two magnets (4 mm × 8 mm) were moved to the PTBD tract and the other magnet (2 mm × 6 mm) was moved to the CBD; the approximation was successful. (E) The approximated magnets were removed, and a new fistula had formed. (F) A fully-covered self-expandable metal stent and plastic stent were inserted into the newly formed fistula.
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