Diagnostic Value of Ultrasound in Detection of Biliary Tract Complications After Liver Transplantation

authors:

avatar Andrej Potthoff 1 , avatar Anreas Hahn 2 , avatar Stefan Kubicka 1 , avatar Andrea Schneider 1 , avatar Jochen Wedemeyer 3 , avatar Juergen Klempnauer 4 , avatar Michael Manns 1 , avatar Michael Gebel 1 , avatar Bita Boozari 1 , *

Department of Gastroenterology, Hannover Medical School, bita.boozari@med.uni-tuebingen.de, Germany
Department of Biometrics, Hannover Medical School, Germany
Department of Internal Medicine, Klinikum Robert Koch Gehrden, Germany
Department of Visceral and Transplant Surgery, Hannover Medical School, Germany

how to cite: Potthoff A, Hahn A , Kubicka S, Schneider A, Wedemeyer J , et al. Diagnostic Value of Ultrasound in Detection of Biliary Tract Complications After Liver Transplantation. Hepat Mon. 2013;13(1):6003. https://doi.org/10.5812/hepatmon.6003.

Abstract

Background:

Biliary complications are significant source of morbidity after liver transplantation (LT). Cholangiography is the gold standard for diagnosis and specification of biliary complications.

Objectives:

Detailed analyses of ultrasound (US) as a safe imaging method in this regard are still lacking. Therefore we analyzed systematically the diagnostic value of US in these patients.

Patients and Methods:

Retrospectively, 128 liver graft recipients and their clinical data were analyzed. All patients had a standardized US examination. The findings of US were compared to cholangiographic results in 42 patients. Following statistical analyses were performed: descriptive statistics, sensitivity, specificity, positive and negative predictive values (PPV, NPV).

Results:

42 patients had 54 different biliary complications (Anastomotic stenosis (AS) n = 33, ischemic type biliary lesions (ITBL) n = 18 and leakage n = 3). US detected n = 22/42 (52%) patients with biliary complications. The sensitivity, specificity, PPV and NPV of US were: 61%, 100%, 100%, 79% (95CI, 36-86%) for ITBL and 24%, 100, 100%, 31% (95CI, 9-46 %) for AS, respectively.

Conclusions:

US examination had no false positive rate. Therefore, it may be helpful as a first screening modality. But for the direct diagnosis of the biliary complication US is not sensitive enough.

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