ULTRASOUND AND CHOLANGIOGRAPHY FOR THE DIAGNOSIS OF BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER-TRANSPLANTATION - A COMPARATIVE-STUDY

The ability of ultrasound to detect biliary obstruction, bile leakage and generalized ductal changes after orthotopic liver transplantation (OLT) was compared to cholangiography. Cholangiography was considered to be the gold standard. Adequate opacification of the biliary tree wa s achieved in 139 cholangiograms. Biliary obstruction, intermediate or large bile leakage, and generalized ductal changes were diagnosed wit h cholangiography in 15% (21/139), 14% (20/139), and 16% (22/139), res pectively. Normal ultrasound findings could not exclude biliary strict ure, generalized ductal changes, or bile leakage, and fluid collection s were not correlated with bile leakage. Abnormal ultrasound findings were highly predictive of the cholangiographic diagnosis of biliary ob struction or generalized ductal changes (specificity of 98% and 100%, respectively). An irregular appearance of the bile ducts and increased periductal echogenicity proved to be characteristic features for gene ralized ductal changes. (C) 1996 John Wiley & Sons, Inc.