Abstract Text
Complete bile duct disconnections after liver transplantation usually require surgical repair, but advanced endoscopic techniques can resolve selected cases. Patient retransplanted in 2024 for ischemic cholangiopathy with Roux-en-Y hepaticojejunostomy and complete ductal disconnection. A duodeno-jejunostomy access with an apposition stent and a hepaticogastrostomy to segment II with a 6-mm covered stent were performed. The first hepaticogastrostomy attempt failed, later corrected with percutaneous drainage and saline distension. ERCP confirmed patency and an anatomical variant, enabling placement of proximal and distal magnets to induce a new anastomosis. One week later, reconnection was documented. Magnetic biliary reconstruction through DY-USE avoided surgical intervention.