Fig. 9.

Hepatic lymphangiography and cholangiography. A 22-gauge needle was passed into the liver and contrast was injected while it was withdrawn, opacifying ( a ) a peripheral lymphatic vessel (black arrow) and biliary radical (white arrow). ( b ) The biliary tree (white arrow) becomes larger as it centralizes, while the lymphatics (black arrow) do not markedly enlarge in size and bifurcate. ( c ) The 22-gauge needle was repositioned centrally in the hepatic hilum and opacified the lymphatics (black arrow), which are tortuous, redundant, and extend to the hepatoduodenal ligament, along the portal vein. Cholecystectomy clips are present at the bottom of the image and a microwire is present in the left hepatic duct and central biliary tree.