Intraoperative three dimensional contrast-enhanced ultrasonic cholangiography in adult living liver donors

Abstract

Objective To assess the feasibility of intra-operative three dimensional contrast-enhanced ultrasonic cholangiography (IO-3D-CEUSC) in adult living liver donors. Methods IO-3D-CEUSC was performed in 8 adult living liver donors. Image quality of IO-3D-CEUSC was evaluated. The visualization of branching orders,coincidence of morphous and biliary variation in IO-3D-CEUSC were compared with those of intraoperative cholangiography using fluoroscopy (IOC). Results The three dimensional biliary tree structures were visualized in all 8 IO-3D-CEUSC. The image quality in the right livers was higher than that of the left livers (P=0.033). The maximum visualization of branching orders in IO-3D-CEUSC was 3.9±0.8,which was equal to the result of IOC (3.7±0.9, P=0.443). The coincidence of morphous was excellent when compared the images between IO-3D-CEUSC and IOC. Two cases with biliary anatomical variation were detected by IO-3D-CEUSC and confirmed by IOC and surgical finding. The time consumption of IO-3D-CEUSC was (10.5±3.1) minutes. No adverse reactions to SonoVue occurred in the donors or recipients during the operation and follow-up. Conclusions IO-3D-CEUSC is a new technique which may be an useful supplement to IOC in evaluation of biliary anatomy and variation before graft harvesting in living donor liver transplantation. Key words: Ultrasonography; Microbubbles; Liver transplantation; Cholangiography