Revista medica del Instituto Mexicano del Seguro Social · 2015
[Usefulness of hepatobiliary scintigraphy in the follow-up of patients with biliary reconstruction].
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sánchez-Fernández Patricio, Martínez-Ordaz José Luis, Sánchez-Reyes Karina, Ferat-Osorio Eduardo
Аннотация
BACKGROUND: The relevance of biliary tract injury patients is not only related to diagnosis and treatment but also to follow-up for the possibility of late complications and medical and legal aspects. Hepatobiliary scintigraphy has played a principal roll in diagnosis of many hepatobiliary diseases.
METHODS: We carried out a descriptive and retrospective study. Included were all patients with biliary tract injuries who underwent biliary reconstruction and liver biopsy. Clinical, laboratory exams and hepatobiliary scintigraphy follow-up was done.
RESULTS: From January 2001 to december 2009 one hundred patients, sixty-five women and thirty-five men were registered. According to Strasberg's classification we had 13 % type E1, 17 % type E2, 38 % type E3 and 32 % type E4. All of them underwent biliary tract reconstruction, eighty-four Hepp-Couinaud type and sixteen conventional jejunum-hepatic anastomosis (Roux-Y). Liver biopsy demonstrated twelve patients with inflammation, forty-nine with cholestasis, nineteen with ductular proliferation and nineteen with fibrosis. When we compare pathologic results of liver biopsy with pre and postoperatively hepatobiliary scintigraphy we found significance in those patients with cholestasis and ductular proliferation in hepatobiliary scintigraphy elimination step, but none in those with inflammation and fibrosis.
CONCLUSIONS: Hepatobiliary scintigraphy is an adequate study to the follow-up of patients who underwent hepatobiliary reconstruction been more significative in patients with cholestasis and ductular proliferation.
METHODS: We carried out a descriptive and retrospective study. Included were all patients with biliary tract injuries who underwent biliary reconstruction and liver biopsy. Clinical, laboratory exams and hepatobiliary scintigraphy follow-up was done.
RESULTS: From January 2001 to december 2009 one hundred patients, sixty-five women and thirty-five men were registered. According to Strasberg's classification we had 13 % type E1, 17 % type E2, 38 % type E3 and 32 % type E4. All of them underwent biliary tract reconstruction, eighty-four Hepp-Couinaud type and sixteen conventional jejunum-hepatic anastomosis (Roux-Y). Liver biopsy demonstrated twelve patients with inflammation, forty-nine with cholestasis, nineteen with ductular proliferation and nineteen with fibrosis. When we compare pathologic results of liver biopsy with pre and postoperatively hepatobiliary scintigraphy we found significance in those patients with cholestasis and ductular proliferation in hepatobiliary scintigraphy elimination step, but none in those with inflammation and fibrosis.
CONCLUSIONS: Hepatobiliary scintigraphy is an adequate study to the follow-up of patients who underwent hepatobiliary reconstruction been more significative in patients with cholestasis and ductular proliferation.