Patency of anastomoses after bilio-intestinal bypass: radioisotope demonstration.
BACKGROUND
Bilio-intestinal bypass (BIB) is effective for the treatment of refractory obesity. BIB permits bile flow into the non-functional jejunum, whereas food transit occurs via the remaining intestine. We used the radioisotope method of 99mTc-Hida cholescintigraphy (HC) in the follow-up of patients.


METHODS
21 patients were studied 3 months to 3 years after BIB with HC. After 3 hours acquisition, images were reviewed by two independent observers. Regions of interest (ROIs) were drawn on images: liver parenchyma, cholecysto-jejunal anastomosis (CC), choledochus (COL). Radioactivity taken up by liver was compared with radioactivity of CC and COL. % radioactivity passing through CC (%CC) and through COL (%COL) were determined. The final parameter, -COL, indicates the radioactive bile which does not pass through the choledochus.


RESULTS
Anastomoses were found patent a few months to 3 years after operation. -COL showed linear correlation with the decrease in cholesterolemia and in body weight in the 1st year after BIB.


CONCLUSIONS
HC shows passage of radioactive bile through anastomoses and provides semiquantitative evaluation of bile flux diversion. Bile flux towards the gallbladder and non-functional jejunal limb far exceeds flux directed towards the duodenum via the choledochus.
Badiali
M
M
Istituto di III Clinica Chirurgica, Università La Sapienza Roma, Italy.
D'Agostini
A
A
Filippis
A M
AM
Corradini
S G
SG
Grossi
A
A
Eramo
A
A
Spera
G
G
Lubrano
C
C
Massa
R
R
Scopinaro
F
F
D000328:Adult; D000714:Anastomosis, Surgical; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D007581:Jejunoileal Bypass; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019780:Technetium Tc 99m Lidofenin
D019275:Radiopharmaceuticals; D019780:Technetium Tc 99m Lidofenin