Hepatobiliary scintigraphy after biliary tract surgery

Detection of a suspected bronchobiliary fistula by hepatobiliary scintigraphy

“…In this case 99m Tc-HIDA scan was the only imaging modality able to confi rm the suspect of BBF. Hepato-biliary scintigraphy, moreover, provides additional information regarding the physiopathology of bile excretion, revealing the presence of obstruction or delayed transit of bile through the intraand extra-hepatic biliary tree, the presence of biliogastric refl ux, bile leakage, and data concerning the liver functionality [19]. Finally, hepatobiliary scintigraphy may be used, as in this case, to evaluate the effectiveness of therapy, such as the closure of the fi stula and the bile leak.…”

Monitoring the hepatobiliary function using image techniques and labeled cholephilic compounds

“…Biliary leak Cholescintigraphy NA [5] Gallstones ERCP PTC [6,7] Cholecystitis Cholescintigraphy NA [8,9] Cholestasis Cholescintigraphy PET-CT [8,10] Hepatic fibrosis Ultrasound elastography MRI, MRE [11][12][13][14][15][16] Liver cancer Ultrasonography CT/MRI [13,17] Liver metastasis MRI/CT NA [15,18] Liver steatosis Ultrasonography NA [12] Obstructed/dilated ducts Cholescintigraphy NA [19,20] ERCP: endoscopic retrograde cholangiopancreatography; MRE: magnetic resonance elastography; NA: none available; PET: positron emission tomography; PTC: percutaneous transhepatic cholangiography Some alternative tests used in liver function evaluation are classical, such as these performed using hepatotropic agents, i.e., efficiently accumulated by the liver or cholephilic compounds, i.e., substances in most part taken up by the liver and secreted into bile. A significant limitation in using these agents to estimate whole liver function is that most of them are not homogeneously distributed throughout the hepatobiliary system.…”

“…When the gallbladder is not filled with the radionuclide imaging agents or there is a decreased clearance of the radiotracer, a functional obstruction of the cystic duct, acute cholecystitis cholestasis, and/or hepatocyte dysfunction can be diagnosed. Furthermore, cholescintigraphy can supply valuable diagnostic information in patients with complications after laparoscopic, partial hepatic resection [19,20,23], or liver transplantation. Moreover, it is the only extracorporeal method to distinguish between chronically dilated ducts, obstructed dilated ducts, and chronically dilated but not obstructed ducts.…”