BACKGROUND: Lacking awareness of biliary variations causes complications in adult living donor liver transplantation. The study was performed to determine the diagnostic value of preoperative multidetector computed tomographic cholangiography (MDCT-CA). METHODS: MDCT-CA after the intravenous administration of meglumine iodipamide was performed in 12 potential liver donors. MDCT angiography was added to depict the topographic relationship between biliary and vascular structures. MDCT findings were correlated with intraoperative findings (n=7). RESULTS: MDCT-CA was diagnostic in all 12 patients. Nine patients revealed variants in biliary anatomy: drainage from liver segment four into right hepatic duct (n=4), additional segmental ducts draining into common (n=4) or left hepatic duct (n=2), and trifurcation at the upper confluence (n=1). Biliary vascular topography was variable and well depicted. Intraoperative assessment confirmed the preoperative findings. CONCLUSIONS: Variations in biliary anatomy appear to be the rule rather than the exception. MDCT-CA represents a noninvasive means for accurately assessing biliary morphology.
BACKGROUND: Lacking awareness of biliary variations causes complications in adult living donor liver transplantation. The study was performed to determine the diagnostic value of preoperative multidetector computed tomographic cholangiography (MDCT-CA). METHODS: MDCT-CA after the intravenous administration of meglumine iodipamide was performed in 12 potential liver donors. MDCT angiography was added to depict the topographic relationship between biliary and vascular structures. MDCT findings were correlated with intraoperative findings (n=7). RESULTS: MDCT-CA was diagnostic in all 12 patients. Nine patients revealed variants in biliary anatomy: drainage from liver segment four into right hepatic duct (n=4), additional segmental ducts draining into common (n=4) or left hepatic duct (n=2), and trifurcation at the upper confluence (n=1). Biliary vascular topography was variable and well depicted. Intraoperative assessment confirmed the preoperative findings. CONCLUSIONS: Variations in biliary anatomy appear to be the rule rather than the exception. MDCT-CA represents a noninvasive means for accurately assessing biliary morphology.