{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:46:51Z","timestamp":1789544811692,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate long-term outcomes of combined endoscopic-percutaneous methods for endoscopically unmanageable anastomotic biliary strictures in living donor liver recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective single-center study included 144 patients referred for biliary stricture between November 2017 and May 2023. Eighty-eight patients (leak\u2009=\u20098, non-anastomotic stricture\u2009=\u20093, treatment refused\u2009=\u200912, successful ERCP\u2009=\u200965) were excluded. Patients initially underwent percutaneous biliary drainage. Patients for whom percutaneous intervention was successful in traversing stricture were followed up with fully-covered self-expandable metallic stents and\/or plastic catheter stents. However, in case of failure, magnetic compression anastomosis (MCA) was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 56 patients (mean age, 59 years \u00b111; 35 men) comprised the study group. Percutaneous intervention was successful in traversing the stricture in 26\/56 patients. Among the remaining 30 patients, 26 were eligible for MCA, which was performed successfully in 24 patients (92%). The mean duration from magnet placement to internalization was 7.71\u2009\u00b1\u20092.77 days (95% CI: 6.54\u20138.88). Altogether, in 47 patients (24 of whom underwent MCA), percutaneous drains were removed following biliary stenting. The mean follow-up was 1082.5\u2009\u00b1\u2009668.2 days (95% CI: 907.49\u20131257.51). In 19 patients (40%), recurrent stricture was evident at ERCP during a median follow-up of 90 (IQR: 60\u2013210) days following stent removal. The recurrent stricture rate following MCA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096\/24) was significantly lower compared to patients in whom MCA was not performed (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913\/23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). Overall, stent type had no significant effect on patency (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.189).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Percutaneous biliary procedures are essential for endoscopically unmanageable post-transplant anastomotic biliary strictures. MCA seems to provide higher patency rates even in patients with total biliary occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>What steps can be taken when endoscopy fails in the treatment of post-transplant anastomotic biliary strictures?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Percutaneous biliary access and magnetic compression anastomosis can be applied to increase graft survival in the setting of endoscopically unmanageable post-transplant biliary strictures.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Impassable biliary obstructions are unfortunate complications and not uncommon in liver transplant recipients. Magnetic compression anastomosis is an alternative minimally invasive method of treatment for complete biliary occlusions.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11634-w","type":"journal-article","created":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T08:08:38Z","timestamp":1745741318000},"page":"6598-6607","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Combined endoscopic-percutaneous approach for magnetic compression anastomosis in post-transplant anastomotic biliary strictures"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1520-2487","authenticated-orcid":false,"given":"Emre","family":"\u00dcnal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00dcmran","family":"Esen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aycan","family":"Uysal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00fcrkmen Turan","family":"\u00c7ift\u00e7i","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devrim","family":"Akinci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erkan","family":"Parlak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"11634_CR1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.21037\/hbsn.2019.09.01","volume":"10","author":"B Magro","year":"2021","unstructured":"Magro B, Tacelli M, Mazzola A, Conti F, Celsa C (2021) Biliary complications after liver transplantation: current perspectives and future strategies. 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