[Hepatobiliary scintigraphy in the diagnosis of common bile duct cysts in children].

A cyst of the common bile duct, the most frequent variant of cystic dilatation of the extrahepatic biliary tract, presents a serious diagnostic problem. Using serial scintigraphy with 99mTc-HIDA 13 children with cysts of the common bile duct confirmed by the results of operative cholangiography, were examined. In 8 of them a radionuclide study was performed at varying times after operation (cyst extirpation with the establishing of hepatoenteroanastomosis--4 patients, and variants of internal drainage operations--4 patients). Typical scintigraphic signs were the following: sacculated or spheroidal dilatation of the common bile duct in combination with dilatation of the left (7), right (1) or both lobular bile ducts, absence of the gall bladder visualization. In the first 15 min of examination in large size cysts zones of the lowered accumulation of the radiopharmaceutical agent were revealed in the area of the portal fissure. Indicators of absorptive-excretory hepatic function changed mainly in children with spheroid-shaped cysts demonstrating alongside with the time of intestinal visualization the degree of disorder of permeability of the choledoch distal parts. The recovery of the anatomic-functional state of the biliferous system occurred earlier (up to 1.5 year) in children after cyst extirpation than after internal drainage operations. It manifested itself in returning the diameter of the bile ducts to normal and in the improvement of absorptive-excretory hepatic function.