RESUMEN
Accurate preoperative reporting is essential in guiding the surgeon in deciding when and how to operate safely and effectively. Critically, this relies on an understanding of the operative issues faced by the surgeon, which is not always appreciated by the radiologist. This paper therefore aims to address this, first focusing on relevant anatomical variants, and then issues specific to laparoscopic cholecystectomy, hepatic transplantation, and finally hepatic resection (including cholangiocarcinoma resection). Throughout the paper, there is an emphasis on associated surgical techniques to add context to the discussion.
Asunto(s)
Conductos Biliares/anatomía & histología , Conductos Biliares/cirugía , Hepatopatías/diagnóstico , Hígado/anatomía & histología , Hígado/cirugía , Cuidados Preoperatorios/métodos , Pancreatocolangiografía por Resonancia Magnética/métodos , Colecistectomía Laparoscópica/métodos , Humanos , Hígado/irrigación sanguínea , Hepatopatías/cirugía , Trasplante de Hígado/métodos , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodosRESUMEN
The complexity of hepatobiliary procedures continues to evolve at a rapid rate, with an increasing number of living donor liver transplants and extensive cancer resections being performed. The associated complications are a significant cause of morbidity and mortality, and are often complex injuries, involving both vascular and biliary structures. In this paper we describe the complications associated with laparoscopic cholecystectomy, liver transplant surgery, and hepatic resection. Focus is on the classical imaging appearances, imaging modality options, and varying management strategies for these injuries, to show how the radiologist's role is vital in ensuring the correct diagnosis is made and the appropriate treatment is instigated.
Asunto(s)
Conductos Biliares/cirugía , Diagnóstico por Imagen/métodos , Hígado/cirugía , Complicaciones Posoperatorias/diagnóstico , Colecistectomía Laparoscópica/efectos adversos , Colecistectomía Laparoscópica/métodos , Humanos , Neoplasias Hepáticas/cirugía , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/métodos , Complicaciones Posoperatorias/etiologíaRESUMEN
Magnetic resonance cholangiopancreatography is a method of evaluating the pancreaticobiliary tree through the use of heavily T2-weighted magnetic resonance images. Despite being introduced approximately 2 decades ago, it remains the best noninvasive diagnostic tool for this purpose, facilitated by advances in imaging acquisition and technique. The purpose of this review is to describe the protocol at our institution, highlight the pitfalls the reader needs to be aware of when interpreting magnetic resonance cholangiopancreatography images, and demonstrate the different pathologies that it can be used to investigate.
Asunto(s)
Enfermedades de los Conductos Biliares/diagnóstico , Conductos Biliares/patología , Pancreatocolangiografía por Resonancia Magnética/métodos , Enfermedades Pancreáticas/diagnóstico , Conductos Pancreáticos/patología , Artefactos , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
Hepatocyte-specific contrast agents have been made available in the last 15 years for magnetic resonance imaging of the liver. These agents are differentially taken up by functioning hepatocytes and excreted in the biliary system. They can help distinguish focal liver lesions of hepatocellular origin from lesions of nonhepatocellular origin, and can also be used in the evaluation of the biliary tree. The purpose of this review is to summarize the different types of hepatocyte-specific contrast agents presently available, their use in the characterization of focal liver lesions, their role in the evaluation of biliary pathology, and their potential future applications.
