ObjectiveTo investigate the value of magnetic resonance (MR) imaging in the assessment of bile duct complications after cholecystectomy. MethodsFifty patients of having bile duct complications after cholecystectomy underwent MR imaging and had some positive manifestations. The indication for cholecystectomy was symptometic cholelithiasis in all cases. MR imaging was performed with a 1.5T clinical imager including all of the sequences of: ①T1 weighted imaging (T1WI) was performed in transverse and coronal plane before and after gadolinium-enhanced. ②T2 weighted imaging (T2WI) was performed in transverse plane. ③A true fast imaging with steadystate precession sequence (True fisp) was performed in coronal plane. ④MR cholangiopancreatography was also obtained. ResultsThe bile duct complications after cholecystectomy including: 22 cases of cholelithiasis, 15 cases of chronic cholangitis with or without bile duct abscess. Bile duct strictures or abruption at the confluence of hepatic and common bile duct in 6 and 3 cases respectively. Tumors of bile duct or pancreas in 9 cases. The other complications after cholecystectomy including bile leak with choleperitonitis and/or biloma and acute pancreatitis.ConclusionMR imaging was a valuable method for the assessment of bile duct complications after cholecystectomy. MR imaging could assess the etiology of bile duct complications. If there were bile duct obstruction, MR imaging could assess the location and the severe of obstruction. For bile duct or pancreatic tumors, MR imaging could assess the areas of tumor infiltration and resection and was helpful to select treatment methods. Before lapatoscopic cholecystectomy, the overall and careful imaging assessment for bile duct and gallbladder and its adjacent hepatic tissue and pancreas so to avoid missing the relative tumors.
Citation：
CHEN Weixia,SONG Bin,CHEN Xiaorong,LIU Rongbo,LU Su.. Assessment of Bile Duct Complications after Cholecystectomy with Magnetic Resonance Imaging. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2004, 11(4): 364-368. doi:
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Khalid TR, Casillas VJ, Montalvo BM, et al. Using MR cholangiopancreatography to evaluate iatrogenic bile duct injury [Ｊ]. AJR Am J Roentgenol, 2001; 177(6)∶1347.
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- 1. 武忠弼,杨光华.中华外科病理学 [M].北京： 人民卫生出版社, 2002∶ 855~914.
- 2. 闵鹏秋,李鹏,何之彦,等.肝内胆管脓肿的CT特征探讨 [Ｊ]. 中华放射学杂志, 2001; 35(5)∶362.
- 3. Ray CE Jr, Hibbeln JF, Wilbur AC. Complications after laparoscopic cholecystectomy: imaging findings [Ｊ]. AJR Am J Roentgenol， 1993; 160(5)∶1029.
- 4. Slanetz PJ, Boland GW, Mueller PR. Imaging and interventional radiology in laparoscopic injuries to the gallbladder and biliary system [Ｊ]. Radiology， 1996; 201(3)∶595.
- 5. Chaudhary A, Negi SS, Puri SK, et al. Comparison of magnetic resonance cholangiography and percutaneous transhepatic cholangiography in the evaluation of bile duct strictures after cholecystectomy [Ｊ]. Br J Surg, 2002; 89(4)∶433.
- 6. Pavone P, Laghi A, Catalano C, et al. MR cholangiography in the examination of patients with biliaryenteric anastomoses [Ｊ]. AJR Am J Roentgenol, 1997; 169(3)∶807.
- 7. Khalid TR, Casillas VJ, Montalvo BM, et al. Using MR cholangiopancreatography to evaluate iatrogenic bile duct injury [Ｊ]. AJR Am J Roentgenol, 2001; 177(6)∶1347.
- 8. Coakley FV, Schwartz LH, Blumgart LH, et al. Complex postcholecystectomy biliary disorders: preliminary experience with evaluation by means of breathhold MR cholangiography [Ｊ]. Radiology, 1998; 209(1)∶141.
- 9. Ward J, Sheridan MB, Guthrie JA, et al. Bile duct strictures after hepatobiliary surgery: assessment with MR cholangiography [Ｊ]. Radiology, 2004; 231(1)∶101.
