Studies on hepatobiliary lymph flow with radioactive colloid--for lymph node metastasis resection of carcinoma of the bifurcation of hepatic duct.

Hepatobiliary lymphoscintigraphy by Technetium 99m-rhenium colloid (99mTc-Re colloid) using a fine needle guided by ultrasonography was performed on 12 patients who underwent resection of the hepatoduodenal ligament lymph nodes. Histological examination revealed no lymph node metastasis in 8 patients. In 4 patients in whom 99mTc-Re colloid was injected into the left medial inferior hepatic segment, periarterial lymph nodes showed higher isotope uptake count than periductal nodes, and lymph nodes around the common hepatic artery revealed higher values than superior posterior pancreatoduodenal nodes. On the contrary, in 3 patients in whom the isotope was injected into the right anterior inferior segment, periductal lymph nodes had higher values than periarterial nodes, and superior posterior pancreatoduodenal lymph nodes showed higher values than those around the common hepatic artery. In one patient in whom the isotope was injected into both right and left segments, superior posterior pancreatoduodenal lymph nodes showed similar values to those around the common hepatic artery. Periportal lymph nodes tended to have values between those of periarterial and periductal ones. Lymph node metastases were confirmed in 4 patients in whom the relationships mentioned above was not always observed, and periportal lymph nodes showed the highest values among the three.