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

AUTHORS

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

1 Department of Gastroenterology, Hannover Medical School, [email protected], Germany

2 Department of Biometrics, Hannover Medical School, Germany

3 Department of Internal Medicine, Klinikum Robert Koch Gehrden, Germany

4 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. doi: 10.5812/hepatmon.6003.

ARTICLE INFORMATION

Hepatitis Monthly: 13 (1); 6003
Published Online: January 20, 2013
Article Type: Research Article
Received: October 27, 2011
Accepted: May 1, 2012
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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.

Keywords

Complications Liver transplantation Cholangiography

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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