Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning
Biliary tract obstruction or anastomotic leakage are common problems following liver transplantation. In a sequential study, 31 patients with a liver transplant were investigated by 99mTc‐IODIDA (IODIDA) scanning and T tube cholangiography (TTC) and the results were compared with clinical outcome. S...
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| Veröffentlicht in: | British journal of surgery 1990-11, Vol.77 (11), p.1233-1237 |
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| creator | Anselmi, M. Lancberg, S. Deakin, M. Lanchbury, E. Drolc, Z. Burrows, F. Elias, E. McMaster, P. |
| description | Biliary tract obstruction or anastomotic leakage are common problems following liver transplantation. In a sequential study, 31 patients with a liver transplant were investigated by 99mTc‐IODIDA (IODIDA) scanning and T tube cholangiography (TTC) and the results were compared with clinical outcome. Seven patients had an extrahepatic biliary obstruction and one patient had a biliary leak. In the detection of biliary complications TTC and IODIDA scanning were similar in terms of sensitivity (63 per cent for both) but TTC had a better specificity (79 per cent versus 60 per cent) and accuracy (74 per cent versus 60 per cent) than IODIDA scanning. When liver function was taken into account, the diagnostic efficacy of both tests in patients with bilirubin levels of 200 umol/l there was a greater number of false positive results with IODIDA scanning (12 per cent versus 54 per cent). The only significant biliary leak was clearly detected by TTC but not IODIDA scanning. TTC remains the more effective way of evaluating the biliary tract after transplantation. IODIDA scanning has limited value when bilirubin levels are elevated, but may provide additional information about blood supply, hepatocyte function and intrahepatic cholestasis. |
| doi_str_mv | 10.1002/bjs.1800771113 |
| format | Article |
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In a sequential study, 31 patients with a liver transplant were investigated by 99mTc‐IODIDA (IODIDA) scanning and T tube cholangiography (TTC) and the results were compared with clinical outcome. Seven patients had an extrahepatic biliary obstruction and one patient had a biliary leak. In the detection of biliary complications TTC and IODIDA scanning were similar in terms of sensitivity (63 per cent for both) but TTC had a better specificity (79 per cent versus 60 per cent) and accuracy (74 per cent versus 60 per cent) than IODIDA scanning. When liver function was taken into account, the diagnostic efficacy of both tests in patients with bilirubin levels of <200 umol/l was similar. With levels >200 umol/l there was a greater number of false positive results with IODIDA scanning (12 per cent versus 54 per cent). The only significant biliary leak was clearly detected by TTC but not IODIDA scanning. TTC remains the more effective way of evaluating the biliary tract after transplantation. IODIDA scanning has limited value when bilirubin levels are elevated, but may provide additional information about blood supply, hepatocyte function and intrahepatic cholestasis.</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.1800771113</identifier><identifier>PMID: 2253001</identifier><language>eng</language><publisher>Bristol: John Wiley & Sons, Ltd</publisher><subject>99mTc-IODIDA scintiscanning ; Adolescent ; Adult ; Aged ; Anastomosis, Roux-en-Y ; biliary anastomosis ; biliary scintigraphy ; biliary tract complication ; biliary tract reconstruction ; Bilirubin - blood ; Child ; Cholangiography ; Choledochostomy ; Cholestasis - diagnosis ; Female ; Humans ; Imino Acids ; Infant ; Liver Transplantation ; Male ; Middle Aged ; Organotechnetium Compounds ; Postoperative Complications - diagnosis ; Postoperative Complications - diagnostic imaging ; Prospective Studies ; Radionuclide Imaging ; Surgical Wound Dehiscence - diagnosis ; T tube cholangiography</subject><ispartof>British journal of surgery, 1990-11, Vol.77 (11), p.1233-1237</ispartof><rights>Copyright © 1990 British Journal of Surgery Society Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3393-2575a7590e6b759abb84265608de9362c45f81df063e91a35ecc7ef2c6ac99de3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.1800771113$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.1800771113$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2253001$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anselmi, M.</creatorcontrib><creatorcontrib>Lancberg, S.</creatorcontrib><creatorcontrib>Deakin, M.</creatorcontrib><creatorcontrib>Lanchbury, E.</creatorcontrib><creatorcontrib>Drolc, Z.</creatorcontrib><creatorcontrib>Burrows, F.</creatorcontrib><creatorcontrib>Elias, E.</creatorcontrib><creatorcontrib>McMaster, P.</creatorcontrib><title>Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Biliary tract obstruction or anastomotic leakage are common problems following liver transplantation. In a sequential study, 31 patients with a liver transplant were investigated by 99mTc‐IODIDA (IODIDA) scanning and T tube cholangiography (TTC) and the results were compared with clinical outcome. Seven patients had an extrahepatic biliary obstruction and one patient had a biliary leak. In the detection of biliary complications TTC and IODIDA scanning were similar in terms of sensitivity (63 per cent for both) but TTC had a better specificity (79 per cent versus 60 per cent) and accuracy (74 per cent versus 60 per cent) than IODIDA scanning. When liver function was taken into account, the diagnostic efficacy of both tests in patients with bilirubin levels of <200 umol/l was similar. With levels >200 umol/l there was a greater number of false positive results with IODIDA scanning (12 per cent versus 54 per cent). The only significant biliary leak was clearly detected by TTC but not IODIDA scanning. TTC remains the more effective way of evaluating the biliary tract after transplantation. IODIDA scanning has limited value when bilirubin levels are elevated, but may provide additional information about blood supply, hepatocyte function and intrahepatic cholestasis.</description><subject>99mTc-IODIDA scintiscanning</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anastomosis, Roux-en-Y</subject><subject>biliary anastomosis</subject><subject>biliary scintigraphy</subject><subject>biliary tract complication</subject><subject>biliary tract reconstruction</subject><subject>Bilirubin - blood</subject><subject>Child</subject><subject>Cholangiography</subject><subject>Choledochostomy</subject><subject>Cholestasis - diagnosis</subject><subject>Female</subject><subject>Humans</subject><subject>Imino Acids</subject><subject>Infant</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organotechnetium Compounds</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Prospective Studies</subject><subject>Radionuclide Imaging</subject><subject>Surgical Wound Dehiscence - diagnosis</subject><subject>T tube cholangiography</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUE1PAjEQbYwGEb16M-nJ22I_aHfXG4IiBuUghmPTLbNQXHZxW1T-vTUQuMzLvDdvMvMQuqakTQlhd9nStWlCSBxTSvkJalIuRcSoTE5RkwQ-opzxc3Th3JIQyolgDdRgTPDQNVHedQ6cW0HpcZVjvwCc2cLqeot9rY3HOvdQ48J-hxqY0q0LXXrtbVXe4wn2mwywWVSBnNtqXuv1YourGg_H_WG_i53RZWnL-SU6y3Xh4GqPLfTx9DjpPUej8WDY644iw3nKIyZioWOREpBZAJ1lSYdJIUkyg5RLZjoiT-gsJ5JDSjUXYEwMOTNSmzSdAW-h293edV19bcB5tbLOQBHOg2rjVEKoEIKxMHizH9xkK5ipdW1X4Wm1Dybo6U7_sQVsDzIl6j91FVJXx9TVw8v7sQveaOe1zsPvwavrTyVjHgs1fRuoQedBDsjrVHH-B2xahQ4</recordid><startdate>199011</startdate><enddate>199011</enddate><creator>Anselmi, M.</creator><creator>Lancberg, S.</creator><creator>Deakin, M.</creator><creator>Lanchbury, E.</creator><creator>Drolc, Z.</creator><creator>Burrows, F.</creator><creator>Elias, E.</creator><creator>McMaster, P.</creator><general>John Wiley & Sons, Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199011</creationdate><title>Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning</title><author>Anselmi, M. ; Lancberg, S. ; Deakin, M. ; Lanchbury, E. ; Drolc, Z. ; Burrows, F. ; Elias, E. ; McMaster, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3393-2575a7590e6b759abb84265608de9362c45f81df063e91a35ecc7ef2c6ac99de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1990</creationdate><topic>99mTc-IODIDA scintiscanning</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anastomosis, Roux-en-Y</topic><topic>biliary anastomosis</topic><topic>biliary scintigraphy</topic><topic>biliary tract complication</topic><topic>biliary tract reconstruction</topic><topic>Bilirubin - blood</topic><topic>Child</topic><topic>Cholangiography</topic><topic>Choledochostomy</topic><topic>Cholestasis - diagnosis</topic><topic>Female</topic><topic>Humans</topic><topic>Imino Acids</topic><topic>Infant</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organotechnetium Compounds</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Prospective Studies</topic><topic>Radionuclide Imaging</topic><topic>Surgical Wound Dehiscence - diagnosis</topic><topic>T tube cholangiography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anselmi, M.</creatorcontrib><creatorcontrib>Lancberg, S.</creatorcontrib><creatorcontrib>Deakin, M.</creatorcontrib><creatorcontrib>Lanchbury, E.</creatorcontrib><creatorcontrib>Drolc, Z.</creatorcontrib><creatorcontrib>Burrows, F.</creatorcontrib><creatorcontrib>Elias, E.</creatorcontrib><creatorcontrib>McMaster, P.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anselmi, M.</au><au>Lancberg, S.</au><au>Deakin, M.</au><au>Lanchbury, E.</au><au>Drolc, Z.</au><au>Burrows, F.</au><au>Elias, E.</au><au>McMaster, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1990-11</date><risdate>1990</risdate><volume>77</volume><issue>11</issue><spage>1233</spage><epage>1237</epage><pages>1233-1237</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><abstract>Biliary tract obstruction or anastomotic leakage are common problems following liver transplantation. In a sequential study, 31 patients with a liver transplant were investigated by 99mTc‐IODIDA (IODIDA) scanning and T tube cholangiography (TTC) and the results were compared with clinical outcome. Seven patients had an extrahepatic biliary obstruction and one patient had a biliary leak. In the detection of biliary complications TTC and IODIDA scanning were similar in terms of sensitivity (63 per cent for both) but TTC had a better specificity (79 per cent versus 60 per cent) and accuracy (74 per cent versus 60 per cent) than IODIDA scanning. When liver function was taken into account, the diagnostic efficacy of both tests in patients with bilirubin levels of <200 umol/l was similar. With levels >200 umol/l there was a greater number of false positive results with IODIDA scanning (12 per cent versus 54 per cent). The only significant biliary leak was clearly detected by TTC but not IODIDA scanning. TTC remains the more effective way of evaluating the biliary tract after transplantation. IODIDA scanning has limited value when bilirubin levels are elevated, but may provide additional information about blood supply, hepatocyte function and intrahepatic cholestasis.</abstract><cop>Bristol</cop><pub>John Wiley & Sons, Ltd</pub><pmid>2253001</pmid><doi>10.1002/bjs.1800771113</doi><tpages>5</tpages></addata></record> |
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| ispartof | British journal of surgery, 1990-11, Vol.77 (11), p.1233-1237 |
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| subjects | 99mTc-IODIDA scintiscanning Adolescent Adult Aged Anastomosis, Roux-en-Y biliary anastomosis biliary scintigraphy biliary tract complication biliary tract reconstruction Bilirubin - blood Child Cholangiography Choledochostomy Cholestasis - diagnosis Female Humans Imino Acids Infant Liver Transplantation Male Middle Aged Organotechnetium Compounds Postoperative Complications - diagnosis Postoperative Complications - diagnostic imaging Prospective Studies Radionuclide Imaging Surgical Wound Dehiscence - diagnosis T tube cholangiography |
| title | Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning |
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