Preliminary Study On The Value Of T-tube Contrast-enhanced Ultrasonic Cholangiography After Liver Transplantation

Objective: To investigate the feasibility of T-tube ultrasound cholangiography in early diagnosis of biliary complications after liver transplantation instead of conventional X-ray cholangiography.Methods: Contrast-enhanced ultrasonic cholangiography(including 2D and 3D imaging)and conventional X-ray angiography were performed in 20 patients at the early stage after liver transplantation.Among them,14 were male and 6 were female,aged53.7±13.2 years,preoperative diagnosis of 10 cases of cirrhosis and 10 cases of cirrhosis with liver cancer,16 cases of whole liver transplantation and 4 cases of split-liver transplantation(right lobe+left medial segment).To evaluate the maximum grade of extrahepatic bile ducts(especially the anastomotic area)and intrahepatic bile ducts in the left and right lobes of the liver by theabove three examinationmethods and their abilityto display bile ducts at different grades,and toevaluate the applicationvalue of t-tube ultrasoundcholangiography in theearly diagnosis of partialbiliary complications after liver transplantation.Results: Except for 2 patients who failed to show intrahepatic bile duct due to T duct prostration,the other 18 patients could show the common hepatic duct and the grade1-2bile duct in the three examinations,which met the diagnostic requirements.The maximum bile duct grade of the three examination methods in the right lobe of liver was higher than that in the left lobe of liver,the difference was significant(P<0.05),but there was no significant difference among the three examination methods(P>0.05).There was no significant difference between the three examination methods in the common hepatic duct and grade 1-3 intrabiliary duct(P>0.05).In comparison of grade 4 intrabiliary duct,two-dimensional ultrasound cholangiography was better than the other two methods,but there was no significant difference among the three examination methods(P=0.05).In comparison of grade 5 intrabiliary duct,two-dimensional ultrasound cholangiography was significantly better than the other two methods(P<0.01),while no significant difference was observed between three-dimensional ultrasound cholangiography and X-ray cholangiography(P>0.05).Among the 20 patients,3 were confirmed to have biliary tract complications,including 2 T-tube prolapse and 1cholangiolithiasis,contrast-enhanced ultrasonic cholangiography(two-dimensional,three-dimensional)clearly showed 3 complications,but X-ray cholangiography only showed T-tube prolapse,which failed to show cholangiolithiasis.Conclusion: There is no significant difference between T-tube ultrasound cholangiography and X-ray cholangiography in displaying bile ducts below grade 3,and it can replace X-ray cholangiography in the diagnosis of biliary complications after transplantation to a certain extent.