Assessment of the biliary tract after liver transplantation: T tube cholangiography or IODIDA scanning

Two common complications following liver transplantation are obstruction of the biliary tract (the gallbladder and its ducts) and bile leakage; such problems occur in about 20 percent of transplant recipients. Thus routine assessment of the biliary tract is performed following the transplant surgery. Two methods of evaluation are T-tube cholangiography (X-ray evaluation of the biliary tract following injection of a contrast medium) and liver-biliary scintigraphy, a noninvasive study which provides a two-dimensional map of the gamma rays emitted by a radioisotope, revealing its tissue concentration and identifying biliary complications. A study was undertaken to compare the diagnostic effectiveness of T-tube cholangiography and IODIDA isotope scintigraphy. There were 31 liver transplant patients who underwent these two diagnostic procedures. Seven patients had biliary obstruction and one patient had bile leakage. The sensitivity of both cholangiography and scanning in detecting obstruction was 63 percent. The cholangiogram was more specific (79 percent versus 60 percent) and more accurate (74 percent versus 60 percent) than was the scanning. The only case of bile leakage was detected by cholangiogram and not by scanning. It is concluded that cholangiogram remains the more effective method of evaluating the biliary tract following liver transplantation. (Consumer Summary produced by Reliance Medical Information, Inc.)