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Three-dimensional demonstration of cystic duct by helical CT scanning
Michiya Kobayashi1, Kimio Matsuura, Keijiro Araki
1First Department of Surgery, Kochi Medical School, Nankoku 783-8505, Japan. kobayasm@kochi-ms.ac.jp
Background/Aims:
We evaluated the usefulness of helical CT scanning with drip-infusion cholangiography for the delineation of choleductal anatomy in preparation for laparoscopic cholecystectomy.
Methodology:
One hundred and five cases underwent laparoscopic cholecystectomy for cholecystolithiasis in our department from March 1993 to July 1998. Endoscopic retrograde cholangiography was carried out in 58 cases and helical CT scanning with drip-infusion cholangiography, including, three-dimensional CT in 31 cases. We, retrospectively, investigated three-dimensional helical CT scanning with drip-infusion cholangiography in the point of three-dimensional demonstration of cystic duct anatomy and try to classify the findings.
Results:
Three-dimensional helical CT scanning with drip-infusion cholangiography visualized three-dimensional anatomy of the cystic duct clearly. For the detection of the biliary disease such as stones and polyps, however, endoscopic retrograde cholangiography is superior (sensitivity; 89.7%) to two-dimensional helical CT scanning with drip-infusion cholangiography (sensitivity; 64.5%) and three-dimensional helical CT scanning with drip-infusion cholangiography (sensitivity; 22.6%) except for large lesions. We have classified the three dimensional helical CT scanning with drip-infusion cholangiography findings in three types.
Conclusions:
Three-dimensional helical CT scanning with drip-infusion cholangiography is not only less invasive but also more useful for the delineation of three-dimensional anatomy of the bile duct.