ABSTRACT
BACKGROUND: Biliary complications that developed after right lobe liver transplantation from living donors were studied in a single centre. METHODS: From 2004 to 2010, 200 consecutive living donor right lobe liver transplantations were performed. The database was evaluated retrospectively. Biliary complications were diagnosed according to clinical, biochemical and radiological tests. The number of biliary ducts in the transplanted graft, the surgical techniques used for anastomosis, biliary strictures and bile leakage rates were analysed. RESULTS: Of a total of 200 grafts, 117 invloved a single bile duct, 77 had two bile ducts and in six grafts there were three bile ducts. In 166 transplants, the anastomosis was performed as a single duct to duct, in 21 transplants double duct to ducts, in one transplant, three duct to ducts and in 12 transplants as a Roux-en-Y reconstruction. In all, 40 bile leakages (20%) and 17 biliary strictures (8.5%) were observed in 49 patients resulting in a total of 57 biliary complications (28.5%). Seventeen patients were re-operated (12 as a result of bile leakages and five owing to biliary strictures). CONCLUSION: Identification of more than one biliary orifice in the graft resulted in an increase in the complication rates. In grafts containing multiple orifices, performing multiple duct-to-duct (DD) or Roux-en-Y anastomoses led to a lower number of complications.
Subject(s)
Anastomotic Leak/epidemiology , Bile Ducts/surgery , Biliary Tract Diseases/etiology , Liver Transplantation/methods , Living Donors , Adolescent , Adult , Aged , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Anastomotic Leak/etiology , Anastomotic Leak/prevention & control , Biliary Tract Diseases/diagnosis , Biliary Tract Diseases/epidemiology , Cholangiopancreatography, Endoscopic Retrograde , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Risk Factors , Turkey/epidemiology , Young AdultABSTRACT
We retrospectively reviewed MR studies on 10 patients with renal-related perinephric fluid collections who underwent MRI in three institutions between January 2001 and August 2004. All patients underwent MRI of the abdomen and T1-weighted, T2-weighted and serial contrast-enhanced images, including delayed-phase contrast-enhanced images 10-12 min after contrast injection, were obtained. Perinephric fluid collections in 5 patients revealed MRI findings of simple fluid content (i.e., hypointense on T1-weighted images and hyperintense on T2-weighted images). In another 5 patients, a complex perinephric fluid content (i.e., mixed hyper/hypointense on T1-weighted images and mixed hypo/hyperintense on T2-weighted images compatible with blood breakdown products and pus) was observed. In 5 patients, contrast extravasation on late-phase images that was compatible with urine leak was demonstrated. Our results suggest that MRI may determine the content of perinephric fluid collections on noncontrast T1-weighted and T2-weighted images and that contrast extravasation on late-phase images is associated with urine extravasation from renal collecting systems.
Subject(s)
Kidney Diseases/diagnosis , Magnetic Resonance Imaging/methods , Adolescent , Adult , Aged , Child , Contrast Media/administration & dosage , Diagnosis, Differential , Female , Gadolinium DTPA/administration & dosage , Hemorrhage/diagnosis , Humans , Hydronephrosis/diagnosis , Injections, Intravenous , Kidney Neoplasms/diagnosis , Male , Middle Aged , Retrospective StudiesABSTRACT
The purpose of this study was to evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) features of juxtapapillary diverticulum. CT and/or MRI examinations of 12 patients were evaluated. The size, location of the diverticula and imaging findings of associated pancreaticobiliary disease were assessed. On CT, oral contrast air level was the characteristic imaging feature. On MRI, T2-weighted images demonstrated the air fluid level with hyperintense fluid and signal void air level above. Associated imaging findings were dilated common bile duct (CBD), cholecystitis, cholecystolithiasis and chronic pancreatitis.
Subject(s)
Ampulla of Vater/diagnostic imaging , Ampulla of Vater/pathology , Diverticulum, Colon/diagnosis , Duodenal Diseases/diagnosis , Magnetic Resonance Imaging/methods , Radiographic Image Enhancement , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde/methods , Contrast Media , Duodenoscopy/methods , Female , Humans , Male , Sampling Studies , Sensitivity and SpecificityABSTRACT
The purpose of our study was to describe the imaging findings of juxtapapillary diverticulum on magnetic resonance imaging (MRI). The MRI and magnetic resonance cholangiopancreatography (MRCP) examinations of 14 patients with juxtapapillary diverticula that were diagnosed on endoscopic retrograde cholangiopancreatography (ERCP) (N = 8) or endoscopy (N = 6) were retrospectively evaluated. T1-weighted spoiled gradient-echo, T2-weighted half Fourier single shot fast spin-echo (HASTE), and T2-weighted True FISP (fast imaging with steady state precession) images and thin-slice MRCP images were obtained on all patients. In five patients, diluted gadolinium DPTA (1/100) was used as an oral contrast. T2-weighted True FISP and HASTE images demonstrated air-fluid levels within all diverticula. Hyperintense oral contrast on T1-weighted spoiled gradient-echo images aided detection of the smaller diverticula. MRCP images obtained in the coronal plane best demonstrated the relationship of the diverticula to the papilla. MRI with the use of HASTE, True FISP, and oral contrast-enhanced T1-weighted sequences was able to depict juxtapapillary diverticula in our series.
Subject(s)
Diverticulum/diagnosis , Duodenal Diseases/diagnosis , Magnetic Resonance Imaging , Aged , Cholangiopancreatography, Endoscopic Retrograde , Contrast Media , Female , Gadolinium DTPA , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Hepatic angiomyolipoma is a rare liver pathology. In this case report, we describe MRI features of a hepatic angiomyolipoma with a high fat content, which was indeterminate on CT. In phase and out of phase T1-weighted spoiled gradient echo technique, T2-weighted fat suppressed fast spin echo technique and dynamic enhanced T1-weighted in phase gradient echo technique were used. Out of phase gradient echo sequence was the most sensitive technique identifying the fat content of the lesion in its mixed tissue composition.