[Imaging of the postoperative biliary tract].
For a long time, imaging of the biliary tract after surgical procedures was performed with invasive procedures such as endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. Due to recent advances in diagnostic imaging, non-invasive techniques are now favored. While US remains the initial imaging modality, it is frequently followed by CT and/or MRCP. Image interpretation should always be performed in keeping with clinical and laboratory findings as well as the type of surgical procedure. The most appropriate imaging modality is selected based on these data. In patients with jaundice or biliary tract stenosis, MRCP, with use of an optimal technique and 3D acquisition, is the imaging modality of choice. In non-jaundiced patients with non-distended biliary tract and suspected bile leak, MRCP should be completed by the injection of a liver-specific contrast agent with biliary excretion to achieve non-invasive biliary tract opacification. In patients with malignancy, CT is preferred due to its high spatial resolution and ability to demonstrate small anastomotic tumor recurrences. CT should also be performed in patients with suspected hepatic artery or portal vein injury in addition to biliary tract injury or to detect distant complications.
Laurent
V
V
Service de Radiologie Adultes, Hôpital de Brabois, Allée du Morvan, 54500 Vandoeuvre lès Nancy, France. v.laurent@chu-nancy.fr
Ayav
A
A
Hoeffel
C
C
Bruot
O
O
Ganne
P-A
PA
Mathias
J
J
Régent
D
D
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001652:Bile Ducts / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D002758:Cholangiography; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000209:etiology; D003135:Common Bile Duct / Q000601:surgery; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives; D012086:Reoperation; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid