Hepatobiliary scintigraphy for detecting biliary strictures after living donor liver transplantation

AIM：To investigate the diagnostic accuracy of hepatobiliary scintigraphy（HBS） in detecting biliary strictures in living donor liver transplantation（LDLT） patients.METHODS：We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-toduct anastomosis,who underwent HBS an...

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Published inWorld journal of gastroenterology : WJG Vol. 17; no. 21; pp. 2626 - 2631
Main Authors Kim, Yu Jin, Lee, Kyu Taek, Jo, Young Cheol, Lee, Kwang Hyuck, Lee, Jong Kyun, Joh, Jae-Won, Kwon, Choon Hyuck David
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 07.06.2011
Subjects
Adult
Bile Ducts - diagnostic imaging
Bile Ducts - pathology
Biliary Tract Diseases - diagnostic imaging
Biliary Tract Diseases - pathology
Biliary Tract Diseases - surgery
Cholangiography - methods
Constriction, Pathologic - diagnostic imaging
Constriction, Pathologic - etiology
Female
Humans
Liver - diagnostic imaging
Liver - pathology
Liver Diseases - diagnostic imaging
Liver Diseases - pathology
Liver Diseases - surgery
Liver Transplantation - adverse effects
Liver Transplantation - diagnostic imaging
Living Donors
Male
Middle Aged
Original
Postoperative Complications - diagnostic imaging
Radionuclide Imaging
Retrospective Studies
功能障碍
显像
检测
活体
狭窄
肝移植
肝脏
胆道
Radionucleotide imaging
Biliary stricture
Hepatobiliary scintigraphy
Tc99m mebrofenin
Living donor liver transplantation
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Summary:AIM：To investigate the diagnostic accuracy of hepatobiliary scintigraphy（HBS） in detecting biliary strictures in living donor liver transplantation（LDLT） patients.METHODS：We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-toduct anastomosis,who underwent HBS and cholangiography.The HBS results were categorized as normal,parenchymal dysfunction,biliary obstruction,or bile leakage without re-interpretation.The presence of biliary strictures was determined by percutaneous cholangiography or endoscopic retrograde cholangiopancreatography（ERCP）.RESULTS：In 89 patients with biliary strictures,HBS showed biliary obstruction in 50 and no obstruction in 39,for a sensitivity of 56.2%.Of 15 patients with no biliary strictures,HBS showed no obstruction in 11,for a specificity of 73.3%.The positive predictive value（PPV） was 92.6%（50/54） and the negative predictive value（NPV） was 22%（11/50）.We also analyzed the diagnostic accuracy of the change in bile duct size.The sensitivity,NPV,specificity,and PPV were 65.2%,27.9%,80% and 95%,respectively.CONCLUSION：The absence of biliary obstruction on HBS is not reliable.Thus,when post-LDLT biliary strictures are suspected,early ERCP may be considered.
Bibliography:Yu Jin Kim, Kyu Taek Lee, Young Cheol Jo, Kwang Hyuck Lee, long Kyun Lee, Jae-Won Joh, Choon Hyuck David Kwon（Department of Medicine,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul 135-710,South Korea ,Department of Surgery,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul 135-710,Korea）
AIM：To investigate the diagnostic accuracy of hepatobiliary scintigraphy（HBS） in detecting biliary strictures in living donor liver transplantation（LDLT） patients.METHODS：We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-toduct anastomosis,who underwent HBS and cholangiography.The HBS results were categorized as normal,parenchymal dysfunction,biliary obstruction,or bile leakage without re-interpretation.The presence of biliary strictures was determined by percutaneous cholangiography or endoscopic retrograde cholangiopancreatography（ERCP）.RESULTS：In 89 patients with biliary strictures,HBS showed biliary obstruction in 50 and no obstruction in 39,for a sensitivity of 56.2%.Of 15 patients with no biliary strictures,HBS showed no obstruction in 11,for a specificity of 73.3%.The positive predictive value（PPV） was 92.6%（50/54） and the negative predictive value（NPV） was 22%（11/50）.We also analyzed the diagnostic accuracy of the change in bile duct size.The sensitivity,NPV,specificity,and PPV were 65.2%,27.9%,80% and 95%,respectively.CONCLUSION：The absence of biliary obstruction on HBS is not reliable.Thus,when post-LDLT biliary strictures are suspected,early ERCP may be considered.
14-1219/R
Living donor liver transplantation; Tc99m mebrofenin; Radionucleotide imaging; Hepatobiliary scintigraphy; Biliary stricture
ObjectType-Article-1
SourceType-Scholarly Journals-1
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Author contributions: Lee KT, Joh JW and Kwon CHD designed the research; Kim YJ and Jo YC performed data collection, analysis and interpretation; Kim YJ and Lee KT drafted the article; Lee KH, Lee JK, Joh JW and Kwon CHD contributed to critical revision of the article.
Telephone: +82-2-34103409 Fax: +82-2-34106983
Correspondence to: Kyu Taek Lee, Professor, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea. happymap@skku.edu
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i21.2626