Biliary tract iatrogenic lesions – importance of selected imaging precision

Congress:

ECR 2022

Poster Number:

C-22213

Type:

Scientific Exhibit

Keywords:

Abdomen, CT, Fluoroscopy, MR-Cholangiography, Cholangiography, Complications, Diagnostic procedure, Acute

Authors:

N. M. Popova, I. Miklaseviča, S. Lapsa, A. Ozolins, A. Buss, M. Radzina

DOI:

10.26044/ecr2022/C-22213

DOI-Link:

https://dx.doi.org/10.26044/ecr2022/C-22213

Purpose

Laparoscopic cholecystectomy is one of the most common surgery types globally, with the potential for iatrogenic biliary tract injuries (IBI). IBI is a serious and potentially life-threatening complication after cholecystectomy, with incidence up to 0.5% for conventional cholecystectomy up to 1.2% for laparoscopic cholecystectomy, which significantly affects the quality of life, and overall survival, and causes frequent medical and legal obligations[1].

Imaging is an important instrument in the detection of these complications and a prerequisite for further management decisions. The most common modalities include endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP), computed tomography (CT), percutaneous transhepatic cholangiogram (PTHC), and ultrasound (US).

Fig 1: Img 1. Strasberg classification of bile duct injuries

Fig 2: Tab 1. Sensitivity, specificity, PPV, NPV, and accuracy of imaging methods for...

Fig 3: Tab 2. Sensitivity, specificity, PPV, NPV, and accuracy of imaging methods for...

Fig 4: Img 2. The US of the abdomen with visualized fluid collection at the epigastric...

Fig 5: Img 3.The CT of the abdomen. Condition after cholecystectomy. Separated fluid...

Fig 6: Img 4. MRCP T2-SPACE with MIP reconstruction. Condition after cholecystectomy....

Fig 7: Img 5. ERCP. Condition after cholecystectomy. Contrast leakage from the bile...

Fig 8: Img 6. Condition after cholecystectomy. Marked intrahepatic cholestasis. A...

Fig 9: Img 7. An 8.5 Fr plastic (endoscopic) stent was implanted through the structure...