Aim. To determine the character of bile outflow in patients who underwent biliary tract reconstructive surgery without any clinical and instrumental evidence of the stricture of biliodigestive anastomosis.Materials and methods. The authors analyzed the findings of radionuclide biliary tract studies conducted in 102 patients with biliodigestive anastomosis from 2016 to 2020. The significant relationship between clinical data and hepatobiliary scintigraphy results was confirmed using Fisher’s exact test.Results. In 75 patients (73.5%), bile outflow disturbance was attributed to the efferent loop motility. Of these cases, 3 (4%) involved paresis of the efferent loop, while 70 (93.3%) exhibited multiple episodes of reflux from the efferent loop into the biliodigestive anastomosis and the intrahepatic bile ducts. In 2 patients (2.6%) showing no clinical signs of chronic cholangitis, a rare reflux from the efferent loop into the biliodigestive anastomosis and the intrahepatic bile ducts was noted.Conclusions. Efferent loop dysfunction can greatly disturb bile outflow following the formation of a biliodigestive anastomosis, thus creating conditions for the development of complications.
Aim. To identify diagnostic value of hepatocholescintigraphy for evaluation of functional state of biliodigestive anastomoses (BDA).Material and methods. 99mTc-IDA hepatocholescintigraphy was applied in 52 patients to evaluate function of biliodigestive anastomoses.Results. Scintigraphic signs of “bowel-anastomosis” and/or “BDA-intrahepatic bile ducts” reflux were revealed in 14 (27%) cases. Obstruction of biliodigestive anastomosis occurred in 3 (5.7%) patients. Normal bile flow through BDA was observed in 10 (19.2%) patients, impaired passage – in 21 (40.3%) cases. Tracer delay in intrahepatic bile ducts was noted in 21 (25.0%) cases, signs of adhesive process near deferent bowel – in 3 (3.8%) cases.Conclusion. Hepatocholescintigraphy is highly effective method to assess biliary tract in patients after Roux-en-Y biliodigestive anastomoses formation.
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