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Background <p>Management of complete biliary obstruction remains challenging when conventional endoscopic or percutaneous approaches fail. Magnetic compression anastomosis (MCA) has emerged as a minimally invasive alternative; however, the evidence base is limited and methodologically heterogeneous. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of MCA in benign and malignant biliary obstruction.</p> Methods <p>On August 27, 2025, we conducted a comprehensive search using PubMed, Scopus, Web of Science, and Cochrane Library for studies evaluating MCA in patients with biliary obstruction. The primary outcome was technical success (anastomosis creation), and secondary outcomes included recurrence rate, incidence of cholangitis, and time to anastomosis creation. Pooled single-arm estimates were calculated using a random-effects model.</p> Results <p>Of 772 articles screened, eight studies were included: 5 on benign biliary stricture (BBS) involving 102 patients, and three on malignant obstruction involving 82 patients. In the BBS group, technical success was 0.91 (95% CI: 0.84–0.95), the recurrence rate was 0.13 (95% CI: 0.034–0.38), and the incidence of cholangitis was 0.029 (95% CI: 0.01–0.087); the mean time to anastomosis creation was 9.89&#xa0;days. In the malignant obstruction group, technical success was 1.00, recurrence rate was 0.073 (95% CI: 0.033–0.15), and incidence of cholangitis was 0.073 (95% CI: 0.033–0.15).</p> Conclusion <p>In this systematic review and meta-analysis, MCA appears to be a feasible and safe procedure, with high technical success rates and low recurrence and cholangitis rates across both groups. Larger comparative studies and randomized controlled trials are needed to confirm these findings.</p>

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The efficacy and safety of magnetic compression anastomosis in the management of biliary obstruction: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月6日

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  • Marwan Desouky,
  • Laith Altawil,
  • Mohammad Al Hayek,
  • Muhammed Elhadi

摘要

Background

Management of complete biliary obstruction remains challenging when conventional endoscopic or percutaneous approaches fail. Magnetic compression anastomosis (MCA) has emerged as a minimally invasive alternative; however, the evidence base is limited and methodologically heterogeneous. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of MCA in benign and malignant biliary obstruction.

Methods

On August 27, 2025, we conducted a comprehensive search using PubMed, Scopus, Web of Science, and Cochrane Library for studies evaluating MCA in patients with biliary obstruction. The primary outcome was technical success (anastomosis creation), and secondary outcomes included recurrence rate, incidence of cholangitis, and time to anastomosis creation. Pooled single-arm estimates were calculated using a random-effects model.

Results

Of 772 articles screened, eight studies were included: 5 on benign biliary stricture (BBS) involving 102 patients, and three on malignant obstruction involving 82 patients. In the BBS group, technical success was 0.91 (95% CI: 0.84–0.95), the recurrence rate was 0.13 (95% CI: 0.034–0.38), and the incidence of cholangitis was 0.029 (95% CI: 0.01–0.087); the mean time to anastomosis creation was 9.89 days. In the malignant obstruction group, technical success was 1.00, recurrence rate was 0.073 (95% CI: 0.033–0.15), and incidence of cholangitis was 0.073 (95% CI: 0.033–0.15).

Conclusion

In this systematic review and meta-analysis, MCA appears to be a feasible and safe procedure, with high technical success rates and low recurrence and cholangitis rates across both groups. Larger comparative studies and randomized controlled trials are needed to confirm these findings.