Abstract
Liver resection consists of the removal of a lobe or segment of the liver, and is usually followed by subsequent regeneration of the remnant parenchyma. Liver resection is mostly indicated not only in malignant tumors, but also in some benign liver conditions. Most of liver resections are “anatomical” which means that they are ruled by vascular landmarks such as portal and hepatic veins. Imaging, especially multiphasic CT, plays a major role in diagnosing and staging the liver disease, helping in surgical treatment planning, and in evaluating postoperative regeneration. CT is also crucial in the postoperative course for diagnosing complications. Most common complications are fluid collections (hematoma, biloma), and vascular complications. Postoperative imaging of the bile ducts is nowadays primarily based on non-invasive imaging modalities and invasive approach should be restricted to interventional procedures. CT scan has several advantages: complete overview of the abdomen, excellent vessels analysis, and pneumobilia depiction. Laparoscopic cholecystectomy is the most common biliary surgery, usually for acute or chronic calculous disease. Bile leakages are the most common complications, usually due to an incomplete cystic duct stump or to an injury because of an anatomical biliary duct variant. They may be revealed early with biliary collection, or lately with bile duct stenosis. Other common biliary surgical procedures are gallbladder resection and bile duct resection for cancer, inflammatory or traumatic lesions. Most early complications are biliary or enteric leaks or hemorrhage, all of them easily diagnosed by CT scan. Most late complications are secondary cholangitis due to stenosis, reflux, or dysfunction, for which CT plays an important role in assessing changes in liver morphology and searching vascular complications.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Abdalla EK (2010) Portal vein embolization (prior to major hepatectomy) effects on regeneration, resectability, and outcome. J Surg Oncol 102(8):960–967
Abir F, Alva S, Longo WE et al (2006) The postoperative surveillance of patients with colon cancer and rectal cancer. Am J Surg 192:100–108
Alves A, Farges O, Nicolet J, Watrin T, Sauvanet A, Belghiti J (2003) Incidence and consequence of an hepatic artery injury in Patients with postcholecystectomy bile duct strictures. Ann Surg 238:93–96
Balzan S, Belghiti J, Farges O (2005) The “50–50 Criteria” on Postoperative Day 5: An Accurate Predictor of Liver Failure and Death After Hepatectomy et al. Ann Surg 242:824–829
Belghiti J, Guevara OA, Noun R, Saldinger PF, Kianmanesh R (2001) Liver hanging manoeuvre: A safe approach to right hepatectomy without liver mobilization. J Am Coll Surg 193:109–111
Brockmann JG, Kocher T, Senninger NJ, Schürmann GM (2002) Complications due to gallstones lost during laparoscopic cholecystectomy. Surg Endosc 16:1226–1232
Chen MF, Hwang TL, Hing CF (1991) Human liver regeneration after major hepatectomy. A study of liver volume by computed tomography. Ann Surg 213:227–229
Clavien PA, Sarr MG, Fong Y (2007) Atlas of upper gastrointestinal and hepato-pancreato-biliary surgery. Springer, Berlin Heidelberg
Couanet D, Shirkhoda A, Wallace S (1984) Computed tomography after partial hepatectomy. J Comput Assist Tomogr 8:453–457
Couinaud C (1957) Le foie: Etudes anatomiques et chirurgicales. Masson, Paris
Feingold DL, Widmann WD, Calhoun SK et al (2003) Persistent post-laparoscopy pneumoperitoneum. Expected or cause for alarm? Surg Endosc 17:296–299
Fong Y, Wagman L, Gonen M et al (2006) Evidence-based gallbladder cancer staging: changing cancer staging by analysis of data from the national Cancer database. Ann Surg 243:767–774
Gagner M, Rogula T, Selzer D (2004) Laparoscopic liver resection: Benefits and controversies. Surg Clin North Am 84:451–462
Gayer G, Jonas ST, Apter S, Amitai M, Shabtai M, Hertz M (2000) Popstoperative pneumoperitoneum as detected by CT: prevalence, duration, and relevant factors affecting its possible significance. Abdom Imaging 25:301–305
Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the seventh ACCP Conference on antithrombotic and thrombolytic therapy. Chest 126(Suppl 3):S388–S400
Gilliland TM, Traverso LW (1990) Modern standards for comparison of cholecystectomy with alternative treatments for symptomatic cholelithiasis with emphasis on long-term relief of symptoms Surg Gynecol Obstet 170(1):39–44
Hawes DR, Pelsang RE, Janda RC, Lu CC (1992) Imaging of the biliary sump syndrome. Am J Roentgenol 158:315–319
Hirano S, Kondo S, Tanaka E et al (2010) Outcome of surgical treatment of hilar cholangiocarcinoma: a special reference to postoperative morbidity and mortality. J Hepatobiliary Pancreat Sci. 17(4):455–462
Hoeffel C, Azizi L, Lewin M et al (2006) Normal and pathologic features of the postoperative biliary tract at 3D MR Cholangiography and MR Imaging. Radiographics 26:1603–1620
Huynh-Charlier I, Taboury J, Charlier P, Vaillant JC, Grenier P, Lucidarme O (2009) Imagerie du foie opéré. J Radiol 90:888–904
Igami T, Nishio H, Ebata T et al (2010) Surgical treatment of hilar cholangiocarcinoma in the “new era”: the Nagoya University experience. J Hepatobiliary Pancreat Sci. 17(4):449–454
Katsihuko Y, Takashi M, Hirochi H et al (1994) Isolated hepatic caudate lobectomy. Surg 115:757–761
Kim JY, Kim KW, Ahn CS et al (2008) Spectrum of biliary and nonbiliary complications after laparoscopic cholecystectomy: radiologic findings. Am J Roentgenol. 191(3):783–789
Kitagawa Y, Nagino M, Kamiya J et al (2001) Lymph node metastasis from hilar cholangiocarcinoma : Audit of 110 patients who underwent regional and paraaortic node dissection. Ann Surg 233:385–392
Kooby DA, Stockman J, Ben-Porat L, Gonen M, Jarnagin WR, Dematteo RP et al (2003) Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann Surg 237:860–870
Laurent V, Ayav A, Hoeffel C et al (2009) Imagerie des voies biliaires opérées. J Radiol 90:905–917
Lee CM, Stewart L, Way LW (2000) Postcholecystectomy abdominal bile collections. Arch Surg 135:538–544
Letourneau JG, Steely JW, Crass JR et al (1988) Upper abdomen: CT finding following partial hepatectomy. Radiology 166:139–141
Lohan D, Walsh S, McLoughlin R, Murphy J (2005) Imaging of the complications of laparoscopic cholecystectomy. Eur Radiol 15:904–912
McAlister VC (2000) Abdominal fluid collection after laparoscopic cholecystectomy British Journal of Surgery 87:1126–1127
Morrin MM, Kruskal JB, Hochman MG, Saldinger PF, Kane RA (2000) Radiologic features of complications arising from dropped gallstones in laparoscopic cholecystectomy patients. Am J Roentgenol 174:1441–1445
Pitre J, Panis Y, Belghiti J (1992) Left hepatic vein kinking after right hepatectomy: a rare cause of acute Budd Chiari syndrome. Br J Surg 79:798–799
Quinn SF, Bodne DJ, Clark RA et al (1988) Upper abdomen: CT finding following partial hepatectomy. Radiology 168:879–880
Schäffer M, Lauper M, Krähenbühl L (2000) A nation’s experience of bleeding complications during laparoscopy. Am J Surg 180:73–77
Sibert A (2010) Aspect post opératoire des voies biliaires. In Imagerie de l’abdomen, Vilgrain V and Regent D, Flammarion Paris
Stumpp P, Kloppel R, Kahn T (2005) Imaging after a Whipple operation. Improving visibility of the afferent jejunal loop in spiral Computed Tomography using biliary contrast medium. J Comput Assist Tomogr 29:394–400
Tanaka K, Uemoto S, Tokunaga Y et al (1993) Surgical techniques and innovations in living related liver transplantation. Ann Surg 217:82–91
Thurley PD, Dhingsa R (2008) Laparoscopic cholecystectomy: Postoperative Imaging, Am J Roentgenol 191:794–801
Vitellas KM, El-Dieb A, Vaswani KK et al (2001) Detection of bile duct leaks using MR cholangiography with IV mangafodipir trisodium (Teslascan). J Comput Assist Tomogr 25:102–105
Walker T (2008) Biliary injury after laparoscopic cholecystectomy: why still a problem? Gastroenterology 134:894–895
Zappa M, Dondero F, Sibert A, Vullierme MP, Belghiti J, Vilgrain V (2009) Liver Regeneration at Day 7 after Right Hepatectomy: Global and Segmental Volumetric Analysis by Using CT. Radiology 252:426–432
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Zappa, M., Sibert, A., Vilgrain, V. (2011). Liver and Biliary System: Postoperative Findings. In: Zech, C., Bartolozzi, C., Baron, R., Reiser, M. (eds) Multislice-CT of the Abdomen. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_408
Download citation
DOI: https://doi.org/10.1007/174_2011_408
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-17862-7
Online ISBN: 978-3-642-17863-4
eBook Packages: MedicineMedicine (R0)