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2015, Number 5

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Rev Med Inst Mex Seguro Soc 2015; 53 (5)

Usefulness of Hepatobiliary scintigraphy in the follow-up of patients with biliary reconstruction

Sánchez-Fernández P, Martínez-Ordaz JL, Sánchez-Reyes K, Ferat-Osorio E

Language: Spanish
References: 17
Page: 538-545
PDF size: 101.87 Kb.


ABSTRACT

Background: The relevance of biliary tract injury patients is not only related to diagnosis and treatment but also to follow-up for the possibility of late complications and medical and legal aspects. Hepatobiliary scintigraphy has played a principal roll in diagnosis of many hepatobiliary diseases.
Methods: we carried out a descriptive and retrospective study. Included were all patients with biliary tract injuries who underwent biliary reconstruction and liver biopsy. Clinical, laboratory exams and hepatobiliary scintigraphy follow-up was done.
Results: from January 2001 to december 2009 one hundred patients, sixty-fi ve women and thirty-fi ve men were registered. According to Strasberg´s classifi cation we had 13 % type E1, 17 % type E2, 38 % type E3 and 32 % type E4. All of them underwent biliary tract reconstruction, eighty-four Hepp-Couinaud type and sixteen conventional jejunum-hepatic anastomosis (Roux-Y). Liver biopsy demonstrated twelve patients with infl ammation, forty-nine with cholestasis, nineteen with ductular proliferation and nineteen with fi brosis. When we compare pathologic results of liver biopsy with pre and postoperatively hepatobiliary scintigraphy we found signifi cance in those patients with cholestasis and ductular proliferation in hepatobiliary scintigraphy elimination step, but none in those with infl amation and fibrosis.
Conclusions: hepatobiliary scintigraphy is an adequate study to the follow-up of patients who underwent hepatobiliary reconstruction been more signifi cative in patients with cholestasis and ductular proliferation.


REFERENCES

  1. Schmidt S, Settmacher U, Langehrs, Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy. Surgery 2004,135:613-618.

  2. Strasberg SM, Herti M, Soper NJ. AN Analysis of the problem of biliary injury during laparoscopic cholecystectomy. J AM Coll Surg 1995;180:101-125.

  3. Massarwech N, Devlin A, Gaston R, Broeckel JA, Flum D. Risk Tolerance and Bile Duct Injury: Surgeon Characteristics, Risk-Taking Preference, and Common Bile Duct Injuries. J Am Coll Surg 2009; 209(1):17-24.

  4. Chaudhary A, Monisegna M, Chandra A. How do bile injuries sustained during laparoscopic cholecystectomy differ from those during open cholecystectomy. J Laparoendosc Adv Surg Tech 2001;4:187-191.

  5. Way LW, Stewart L, Ganter W. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 2003;237:460-469.

  6. Alves A. Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct stricture. Ann Surg 2003;238:93-96.

  7. Strasberg S. Biliary Injury in Laparoscopic Surgery: Part 1. Processes Used in Determination of Standard of Care in Misidentifi cation Injuries. J Am Coll Surg 2005;201(4):598-603.

  8. Strasberg S. Biliary Injury in Laparoscopic Surgery: Part 2. Changing the Culture of Cholecystectomy. J Am Coll Surg 2005;201(4):604-611.

  9. Ziessman H, O´Malley J, Thrall J, Capítulo 7 Sistema Hepatobiliar. En: Ziessman H, O´Malley J, Thrall J, editores. Medicina Nuclear Los Requisitos en Radiología. Madrid: Elsevier 2007; p.159-214.

  10. Negi SS, Sakhuya P, Malharta V, Chaudhug NJ. Factors Predicting Advanced Hepatic Fibrosis in Patients with Postcholecystecomy Bile Duct Strictures. Arch Surg 2004;139(3):299-303.

  11. Kuribayashi S, Monden T, Nakajima H, Ishizuka T, Kusano M, Mori M. Uselfuness of cholescintigraphy with lipid meal loading for diagnosis and determination of cholecystectomy in a patient with gallbladder dysfunction. Intern Med 2004;43(5):393-396.

  12. Tripathi M, Chandrashekar N, Kumar R, Thomas EJ, Agarwal S, Bal CS, Malhota A. Hepatobiliary scintigraphy: an effective tool in the management of bile leak following laparoscopic cholecystectomy. Clin Imaging 2004;28(1):40-43.

  13. Balakrishnan VB, Vumar R, Dhampathi H. Hepatobiliary scintigraphy in detecting lesser sac bile leak in postcholecystectomy patients: The need to recognize as a separate entity. Clin Nucl Med 2008;33(3): 161-167.

  14. Nishigushi S, Shiomi S, Sasaki N. A case of recurrent cholangitis after bile duct injury during laparoscopic cholecystectomy: value of scintigraphy with Tc-99m GSA and hepatobiliary scintigraphy for indication ofl obectomy. Ann Nucl Med 2000;14(5):383-386.

  15. Fialkowsky E, Winslow E, Scott M, Hawkings W, Linehan D, Strasberg S. Establishing “Normal” Values for LIver Function Tests after Reconstruction of Biliary Injuries. J Am Coll 2008;207(5):705-709.

  16. Sheen-Chen SM,Hung KS, Ho HT, Chen WJ, Eng HL. Effect of Glutamine and Bile Acid on Hepatocyte Apoptosis after Bile Duct Ligation in Rat. World J Surg 2004; 28:457-460.

  17. Hammel P, Couvelard A, O´Toole D. Regression of liver fi brosis after biliary drainage in patients with chronic pancreatitis and stenosis of the common bile duct. N Eng J Med 2001;344:418-423.




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