^99mTc-IDA Hepatobiliary Imaging Following Upper Abdominal Surgery

Abstract

Bile flow patterns were studied with serial 99mTc-IDA images in 19 patients with cholecysto- and choledochointestinal anastomoses, gastroenteric bypasses, and combinations of the two. Complications such as anastomotic, afferent, and efferent loop obstruction and bile leakage were readily detected even in the presence of jaundice. This noninvasive technique warrants further investigation to determine its indications and weaknesses.

SNM Practice Guideline for Hepatobiliary Scintigraphy 4.0

“…Assessment of liver transplant (11,46-51) 10. Afferent loop syndrome (52)(53)(54)(55)(56) 11. Assessment of choledochal cysts (11,(57)(58)(59)(60)(61)(62)(63)(64) 12.…”

Detection of intraperitoneal bile accumulations: Significance of ultrasonography, CT, and cholescintigraphy

“…Even leakage of an anastomosis after choledochoenterostomy is revealed in an innocuous way. The diagnosis of anastomosis leakage would be difficult to obtain with ultrasonography or CT [13,23]. One case of bile leakage into a hepatic abscess in a liver transplant detected by cholescintigraphy has been reported by Klingensmith et al [9].…”

“…However, intraperitoneal bile leakage per se is not important if it is sterile and the rent in the biliary tract is small. Such a tear will usually seal spontaneously [13]. This may be the reason for so few reports of common bile duct leakage following T-tube removal [14].…”

Afferent loop obstruction documented with hepatobiliary imaging

“…Due to the microcurie amounts of 1311 employed, the images obtained are of poorer quality than those obtained with 99mTc-labeled hepatobiliary agents. Rosenthall et al [9] used the newer 99mTc-hepatobiliary agents in the evaluation of pa- tients after upper abdominal surgery. Their series includes instances of afferent loop obstruction due to fibrosis at the anastomotic site.…”