Bile leakage after living donor liver transplantation demonstrated with hepatobiliary scan using 9mTc-PMT.
Although it is recognized that hepatobiliary scan is of value in assessing postoperative complications of biliary surgery or cadaveric whole liver transplantation, there have been few reports regarding its usefulness following living donor liver transplantation. We performed living donor liver transplantation in a patient with biliary cirrhosis due to hepatolithiasis, using a right lobe graft from her sister. On the 15th postoperative day, bile discharge appeared from the operative wound. The leakage point could not be identified by computed tomography and cholangiography from the biliary drainage catheter. Hepatobiliary scan with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) demonstrated biliary extravasation from the left side of the anastomosis of the hepatico-jejunostomy, indicating biliary leakage from the anastomosis. Conservative therapy was continued because the radioisotope flowed smoothly into the reconstructed jejunum and the biliary drainage catheter, and the leakage was stopped on the 63th postoperative day. Hepatobiliary scan is useful in determining the therapeutic plan as well as detection of bile leakage and identification of leakage points after living donor liver transplantation.
Department of Gastroenterological and Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Japan. m1644322@msic.med.osaka-cu.ac.jp
Akishige
A
Kanazawa
Shoji
S
Kubo
Hiromu
H
Tanaka
Shigekazu
S
Takemura
Keiichi
K
Yamazaki
Kazuhiro
K
Hirohashi
Susumu
S
Shiomi
D000328:Adult; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D001652:Bile Ducts / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D019520:Living Donors; D015609:Organotechnetium Compounds; D011759:Pyrrolidines; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013752:Tetracycline
D015609:Organotechnetium Compounds; D011759:Pyrrolidines; D019275:Radiopharmaceuticals; C057732:technetium Tc 99m pyrrolidino-methyltetracycline; D013752:Tetracycline