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Article
June 1983

Total Bile Duct ObstructionPrompt Diagnosis by Hepatobiliary Imaging

Author Affiliations

From the Departments of Radiological Sciences (Drs Egbert and Braunstein) and Surgery (Dr Miller), University of California—Irvine Medical Center, Orange, and the Department of Nuclear Medicine, Veterans Administration Medical Center, Long Beach, Calif (Dr Lyons). Dr Egbert is now with St John's Regional Health Center, Springfield, Mo.

Arch Surg. 1983;118(6):709-712. doi:10.1001/archsurg.1983.01390060031006
Abstract

• The value of hepatobiliary imaging for the early diagnosis of total bile duct obstruction is not well known. Four hundred eighteen technetium Tc 99m iprofenin (Pipida) hepatobiliary scans were reviewed, and the anatomic diagnosis was established by postmortem examination, laparotomy, endoscopic retrograde cholangiopancreatography, transhepatic cholangiography, or ultrasound. Sixty cases demonstrated the technetium Tc 99m iprofenin pattern of total bile duct obstruction. Of these, 41 had total bile duct obstruction, 14 had advanced hepatocellular disease, four had massive liver metastasis, and one had portal vein thrombosis. The test was 100% sensitive for the detection of total bile duct obstruction. When the bilirubin level was less than 10 mg/dL, the predictive value was 100%. As the bilirubin level rose to 15 and 20 mg/dL, the predictive value fell to 92% and 88%, respectively. If performed early, hepatobiliary scanning is the preferred test for suspected total bile duct obstruction.

(Arch Surg 1983;118:709-712)

References
1.
Harvey E, Loberg M, Cooper M:  Tc-99m-HIDA: A new radiopharmaceutical for hepato-biliary imaging , abstracted. J Nucl Med 1975;16:533.
2.
Loberg MD, Cooper M, Harvey E, et al:  Development of new radiopharmaceuticals based on N-substitution of iminodiacetic acid . J Nucl Med 1976;17:633-638.
3.
Harvey E, Loberg M, Ryan J, et al:  Hepatic clearance mechanisms of Tc-99m-HIDA and its effect on quantitation of hepatobiliary function: Concise communication . J Nucl Med 1979;20:310-313.
4.
Weissmann HS, Rosenblatt RR, Sugarman LA, et al:  Early diagnosis of acute common bile duct obstruction by Tc-99m-IDA (iminodiacetic acid) cholescintigraphy , abstracted. J Nucl Med 1980;21:41.
5.
Gliedman ML, Wilk PJ:  A surgeon's view of hepatobiliary scintigraphy . Semin Nucl Med 1982;12:2-4.Article
6.
Ryan J, Cooper M, Loberg M, et al:  Technetium-99m labeled N-(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (Tc-99m HIDA): A new radiopharmaceutical for hepatobiliary imaging studies . J Nucl Med 1977;18:995-1002.
7.
Weissmann HS, Badia J, Sugarman LA, et al:  Spectrum of cholescintigraphic patterns in acute cholecystitis . Radiology 1981;138:167-175.Article
8.
Szlabick RE, Catto JA, Fink-Bennett D, et al:  Hepatobiliary scanning in the diagnosis of acute cholecystitis . Arch Surg 1980;115:540-544.Article
9.
Weissmann HS, Sugarman LA, Freeman LM:  The clinical role of technetium-99m iminodiacetic acid cholescintigraphy . Nucl Med Annu , 1981, pp 35-80.
10.
Fonseca C, Rosenthall L, Greenberg D, et al:  Differential diagnosis of jaundice by 99m Tc-IDA hepatobiliary imaging . Clin Nucl Med 1979;4: 135-142.Article
11.
Rosenthall L, Shaffer EA, Lisbona R, et al:  Diagnosis of hepatobiliary disease by 99mTc-HIDA cholescintigraphy . Radiology 1978;126:467-474.Article
12.
Patton DD:  Introduction to clinical decision making . Semin Nucl Med 1978;8:273-282.Article
13.
Egbert RN, Lyons KP, Braunstein P:  Superiority of PIPIDA over ultrasound for early diagnosis of common bile duct obstruction , abstracted. Clin Nucl Med 1982;7:36.Article
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