Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis
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- 作者：Jae Seung Kim ; Dae Hyuk Moon ; Sung Gyu Lee ; Yung Joo Lee ; Kwang Min Park ; Jung Woo Shin ; Jin Sook Ryu and Hee Kyung Lee
- 关键词：Key words ; Technetium ; 99m DISIDA – ; Biliary obstruction – ; Hepatic resection – ; Biliary ; enteric anastomosis
- 刊名：European Journal of Nuclear Medicine and Molecular Imaging
- 出版时间：February 2000
- 出版年：2000
- 期刊代码：62_1619-7070
- 类别：med
- 卷：27
- 期：2
- 页码：170-175
- 数据来源：sp
摘要
We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94%(16/17) and 97%(50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis.