Evaluation of the Compatibility of Preoperative MRCP and Intraoperative Cholangiography in Imaging of the Bile Ducts in Living Donor Liver Transplantation

To evaluate the compatibility of preoperative 3D magnetic resonance cholangiopancreatography (3D MRCP) and intraoperative cholangiographies (IOC) of donors using Huang classification in living donor liver transplantation. Thirty-six consecutive right donor hepatectomy cases were retrospectively analyzed with preoperative MRCP and intraoperative cholangiography. Biliary variants were determined according to the Huang classification. Compatibility in MRCP and IOC was evaluated. 3D MRCP accurately determined the biliary anatomy in 32 of 36 cases (88.88%). The IOC of the 36 donors showed 25 normal bifurcations and 11 biliary variants. For detecting normal and variant anatomy, sensitivity, specificity, PPV, and NPV were 96.0%, 72.7%, 88.9%, and 88.9.0%, respectively. There was a substantial inter-rater agreement between IOC and MRCP in determining normal and variant anatomy (κ = 0.724, p < 0.001). 3D MRCP is a non-invasive useful method to evaluate non-dilated bile ducts preoperatively in living donor liver transplantation. The eligibility criteria determined according to preoperative MRCP images should also be confirmed by intraoperative cholangiography.