technetium-tc-99m-mebrofenin and Gallbladder-Neoplasms

The aim of this study was to assess the safety and efficacy of extended liver venous deprivation (eLVD), i.e. combination of right portal vein embolisation and right (accessory right) and middle hepatic vein embolisation before major hepatectomy for future remnant liver (FRL) functional increase.. eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2.69%/min/m. Ten consecutive patients underwent eLVD before surgery for liver metastases (n = 8), Klatskin tumour (n = 1) and gallbladder carcinoma (n = 1). FRL function increased by 64.3% (range = 28.1-107.5%) at day 21. In patients with serial measurements, maximum FRL function was at day 7 (+65.7 ± 16%). The FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day). Thirty-one days (range = 22-45 days) after eLVD, 9/10 patients were resected. No post-hepatectomy liver failure was reported. Two grade II and one grade III complications (Dindo-Clavien classification) occurred. No patient died with-in 90 days following surgery.. eLVD is safe and provides a marked and very rapid increase in liver function, unprecedented for an interventional radiology procedure.. • eLVD is safe • eLVD provides a marked and very rapid increase in liver function • After eLVD, the FRL-F increased by 64.3% (28.1-107.5%) at day 21 • After eLVD, the maximum FRL-F was obtained at day 7 (+65.7 ± 16%) • After eLVD, the FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day).

Topics: Aged; Aniline Compounds; Bile Duct Neoplasms; Embolization, Therapeutic; Female; Gallbladder Neoplasms; Glycine; Hepatectomy; Hepatic Veins; Humans; Imino Acids; Klatskin Tumor; Liver; Liver Failure; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Portal Vein; Preoperative Care; Radiopharmaceuticals; Retrospective Studies; Single Photon Emission Computed Tomography Computed Tomography; Tomography, X-Ray Computed

Topics: Aged; Aged, 80 and over; Aniline Compounds; Colorectal Neoplasms; Combined Modality Therapy; Embolization, Therapeutic; Female; Gallbladder Neoplasms; Glycine; Hepatectomy; Humans; Imino Acids; Liver; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Portal Vein; Radiopharmaceuticals; Salvage Therapy; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

Intrabiliary rupture is the most common complication of hepatic hydatid cyst yet it is unusual, occurring in only 3-17% of cases. The diagnosis is rarely difficult on ultrasound and CT when typical radiological features are present. In rare cases of complete evacuation, when characteristic findings of hydatid cyst are absent or when there is no evidence of the previous existence of liver hydatid cyst, the diagnosis may be difficult. In difficult cases, MRI, MRCP, ERCP and (99)Tc(m)-mebrofenin hepatobiliary scintigraphy are employed. We present a rare case of surgical obstructive jaundice due to rupture of a liver hydatid cyst into the biliary tract and gall bladder, with complete evacuation of its contents leading to misdiagnosis on CT and ultrasound. MRCP and (99)Tc(m)-mebrofenin hepatobiliary scintigraphy were able to establish a firm pre-operative diagnosis.

Topics: Aniline Compounds; Biliary Tract Diseases; Diagnosis, Differential; Echinococcosis, Hepatic; Gallbladder Neoplasms; Glycine; Humans; Imino Acids; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Rupture, Spontaneous; Tomography, X-Ray Computed