Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection release_55wil6sb4fbqlmsklv4ypynkdm

by Manuel Eckenschwiller, Hanns Ackermann, Wolf O. Bechstein, Frank Grünwald

Published in International Journal of Molecular Imaging by Hindawi Limited.

2016   Volume 2016, p1-8

Abstract

<jats:italic>Background and Aims. </jats:italic>Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS) and impact of hyperbilirubinemia were evaluated.<jats:italic> Methods. </jats:italic>Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">13</mml:mn></mml:math>) or hepatic resection (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">26</mml:mn></mml:math>) were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated.<jats:italic> Results. </jats:italic>HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14). Overall diagnostic accuracy was 76% (19/25) in this group and 54% (7/13) in the LTX group. False negative (FN) diagnoses occurred more often among LTX patients (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.011</mml:mn></mml:math>). Hyperbilirubinemia (&gt;5 mg/dL) significantly influenced the excretion function of the liver, prolonging HBS's time-activity-curve (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>).<jats:italic> Conclusions. </jats:italic>Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.
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Type  article-journal
Stage   published
Year   2016
Language   en ?
DOI  10.1155/2016/7857849
PubMed  27563464
PMC  PMC4987481
Wikidata  Q41732884
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