title: Hepatobiliary scintigraphy for detecting biliary strictures after living donor liver transplantation.
abstract: OBJECTIVE
  To investigate the diagnostic accuracy of hepatobiliary scintigraphy (HBS) in detecting biliary strictures in living donor liver transplantation (LDLT) patients.
  
  
  METHODS
  We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-to-duct anastomosis, who underwent HBS and cholangiography. The HBS results were categorized as normal, parenchymal dysfunction, biliary obstruction, or bile leakage without re-interpretation. The presence of biliary strictures was determined by percutaneous cholangiography or endoscopic retrograde cholangiopancreatography (ERCP).
  
  
  RESULTS
  In 89 patients with biliary strictures, HBS showed biliary obstruction in 50 and no obstruction in 39, for a sensitivity of 56.2%. Of 15 patients with no biliary strictures, HBS showed no obstruction in 11, for a specificity of 73.3%. The positive predictive value (PPV) was 92.6% (50/54) and the negative predictive value (NPV) was 22% (11/50). We also analyzed the diagnostic accuracy of the change in bile duct size. The sensitivity, NPV, specificity, and PPV were 65.2%, 27.9%, 80% and 95%, respectively.
  
  
  CONCLUSIONS
  The absence of biliary obstruction on HBS is not reliable. Thus, when post-LDLT biliary strictures are suspected, early ERCP may be considered.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Young Cheol
authors.initials: YC
authors.lastname: Jo
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.forename: Choon Hyuck David
authors.initials: CH
authors.lastname: Kwon
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000000981:diagnostic imaging* / Q000473:pathology; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002758:Cholangiography / Q000379:methods; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012189:Retrospective Studies