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Clinical usefulness of T1-weighted MR cholangiography with Gd-EOB-DTPA for the evaluation of biliary complication after liver transplantation

Annals of Hepato-Biliary-Pancreatic Surgery 2021년 25권 1호 p.39 ~ 45
임창진, 홍광표, 이정무, Han Eui-Soo, 홍석균, 최영록, 이남준, 이광웅, 서경석,
소속 상세정보
임창진 ( Lim Chang-Jin ) - Seoul National University College of Medicine Department of Surgery
홍광표 ( Hong Kwang-pyo ) - Seoul National University College of Medicine Department of Surgery
이정무 ( Lee Jeong-Moo ) - Seoul National University College of Medicine Department of Surgery
 ( Han Eui-Soo ) - Seoul National University College of Medicine Department of Surgery
홍석균 ( Hong Suk-Kyun ) - Seoul National University College of Medicine Department of Surgery
최영록 ( Choi Young-Rok ) - Seoul National University College of Medicine Department of Surgery
이남준 ( Yi Nam-Joon ) - Seoul National University College of Medicine Department of Surgery
이광웅 ( Lee Kwang-Woong ) - Seoul National University College of Medicine Department of Surgery
서경석 ( Suh Kyung-Suk ) - Seoul National University College of Medicine Department of Surgery

Abstract


Backgrounds/Aims: Biliary complications continue to be the major morbidity and mortality causes following living donor liver transplantation (LT). Endoscopic retrograde cholangiopancreatography (ERCP) has been performed to identify the biliary leakage source. However, this can lead to retrograde cholangitis and pancreatitis, and is not sufficient to diagnose bile leakage from cuts’ surface. This study aimed to describe the use of T1-Weighted Magnetic Resonance (MR) Cholangiography with Gd-EOB-DTPA (Primovist) examination for evaluating the bile duct complication following LT.

Methods: From March 2012 to December 2018, 869 adult LT were performed at the Seoul National University Hospital. Forty-three recipients had undergone MR Cholangiography with Gd-EOB-DTPA. We reviewed these cases with their clinical outcomes and described the utility of the MR cholangiography with Gd-EOB-DTPA.

Results: In radiologic examinations performed in the patients suspected of bile duct complication, 95% had bile leakage and stricture. Cut surface leakage was diagnosed in two cases, and biliary leakage from the anastomosis site was diagnosed in the others. Most patients with leakage had undergone percutaneous drainage and ERCP, which was performed to evaluate the bile secretion function of the hepatocytes. There was no contrast-enhanced bile duct image in one case with severe rejection, and it might have been related to hepatocyte secretary dysfunction.

Conclusions: T1-Weighted MR Cholangiography with Gd-EOB-DTPA 40-minute delay examination is a feasible and safe non-invasive procedure for identifying biliary leakage sites.

키워드

Gd-EOB DTPA MRI; Liver transplantation; Biliary complication

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