ABSTRACT
In 44 patients who had been operated upon for benign obstruction of the biliary tract and had undergone sphincteroplasty or choledochoduodenostomy seven to 12 years previously, patency of the new stoma was evaluated. Dynamic studies of bile flow were done by radioisotopic cholangiography, using 99mTc-pyridoxal-phenylalanine as an hepatobiliary imaging agent. Both surgical procedures seem to give equal results in the long term follow-up study regarding the patency of a new stoma. In view of the fact that choledochoduodenostomy involves less morbidity and mortality postoperatively, than does sphincteroplasty, the former is preferred unless a stone is impacted into the ampulla of Vater or if the common bile duct is less than 2 centimeters in diameter in instances of stricture.
Subject(s)
Ampulla of Vater/surgery , Cholestasis/surgery , Common Bile Duct Diseases/surgery , Common Bile Duct/surgery , Duodenum/surgery , Sphincter of Oddi/surgery , Biliary Tract/diagnostic imaging , Cholestasis/diagnostic imaging , Common Bile Duct Diseases/diagnostic imaging , Gallstones/surgery , Humans , Methods , Radionuclide ImagingABSTRACT
In this experimental study, the usefulness of a new radiotracer, Tc-99m pyridoxal-phenylalanine ("Tc-PPh"), is evaluated as a hepatobiliary imaging agent, and results are compared with those of conventional cholangiography. In the presence of a normal biliary tree or in cholelithiasis, information derived from conventional cholangiography is of better quality. The radiotracer technique, however, is very useful for the demonstration of cholopeptic bypass procedures, even in the presence of jaundice, and also in cases of intraperitoneal bile leakage.
Subject(s)
Biliary Tract/diagnostic imaging , Liver/diagnostic imaging , Phenylalanine , Pyridoxal , Technetium , Animals , Cholangiography , Cholelithiasis/diagnostic imaging , Cholestasis/diagnostic imaging , Dogs , Gallbladder/diagnostic imaging , Kidney/diagnostic imaging , Mice , Rabbits , Radionuclide ImagingABSTRACT
Twenty-four patients with normal or diseased hepatobiliary systems were subjected to a clinical trial in order to evaluate Tc-99m pyridoxal-phenylalanine as a biliary imaging agent. The investigation was combined with i.v. cholecysto-cholangiography in most cases, and the results were compared. It is concluded that qualitative information derived from conventional i.v. cholangiography is better in demonstrating the normal biliary tree or gallstones. The radiotracer techniques, however, are valuable in dynamic studies of Oddi's sphincter, in showing patency of biliary by-pass procedures, and in differentiating hepatocellular from obstructive jaundice.
Subject(s)
Biliary Tract/diagnostic imaging , Liver/diagnostic imaging , Phenylalanine , Pyridoxal , Technetium , Aged , Biliary Tract Diseases/diagnostic imaging , Cholangiography , Cholecystography , Cholelithiasis/diagnostic imaging , Cholestasis/diagnostic imaging , Female , Humans , Liver Diseases/diagnostic imaging , Male , Middle Aged , Radionuclide Imaging , Sphincter of Oddi/diagnostic imagingABSTRACT
A new "bone seeking" agent, namely the organic compound diphosphonate labeled with Tc99m was tried in 21 patients for skeletal scanning. In 3 cases, although the clinical and roentgenographic evidence of bone lesions was absent, bone metastases were found, and these were confirmed histologically. The organic diphosphonate is more stable compared to the inorganic polyphosphates and the images obtained are excellent.
