tetracycline and Bile-Duct-Diseases

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.

Topics: Adult; Bile Duct Diseases; Bile Ducts; Female; Humans; Liver; Liver Transplantation; Living Donors; Organotechnetium Compounds; Pyrrolidines; Radionuclide Imaging; Radiopharmaceuticals; Tetracycline

A 41-year-old woman underwent laparoscopic cholecystectomy for the treatment of gallstone and adenomyomatosis. One month after laparoscopic cholecystectomy, hepatobiliary scintigraphy was performed with 99mTc-Sn-N-pyridoxyl-5-methyltryptophan (PMT) to evaluate the presence of a bile leak and/or other complication. A biliary extravasation was noted in the left upper quadrant within 60 minutes. At five hours post injection, a progressive accumulation of 99mTc-PMT was noted in the lesser sac, the right and left paracolic gutter and in the pouch of Douglas. A diagnosis of biliary leakage was made. The patient underwent exploratory laparotomy to repair the leak from the cystic duct stump.

Topics: Adult; Bile Duct Diseases; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Humans; Organotechnetium Compounds; Pyrrolidines; Radionuclide Imaging; Tetracycline; Tetracyclines

Topics: Anti-Bacterial Agents; Bile; Bile Duct Diseases; Common Bile Duct; Cystic Duct; Hepatobiliary Elimination; Humans; Tetracycline

Topics: Bile; Bile Duct Diseases; Common Bile Duct; Cystic Duct; Hepatobiliary Elimination; Humans; Tetracycline

Topics: Bile Duct Diseases; Bile Ducts; Hepatobiliary Elimination; Humans; Protein Synthesis Inhibitors; Tetracycline