TITLE

EVALUATING MRC AGAINST ERCP IN THE ASSESSMENT OF BILE DUCT STONES

AUTHOR(S)
Shafiq, K.; Thomas, E.; Brett, B.; Jamieson, C.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA25
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Aim: To evaluate magnetic resonance cholangiography (MRC) in the detection of bile duct stones. Methods: The study was performed over 2 years. Patients presenting with biliary symptoms who were assessed as having a Iow to medium probability of bile duct stones according to predefined criteria had an MRC. In general patients who had positive MRC had an endoscopic retrograde cholangiogram (ERCP), while patients who had a negative MRC did not have further biliary imaging. MRC and ERCP data were gathered prospectively. At completion of the study the patients who had both procedures were compared for presence of stones on each modality. A rigorous retrospective case notes review was carried out for all those who had a negative MRC to spot subsequent admissions related to probable biliary disease, biliary symptoms in new referral or follow up clinic letters and mortality. Results: 229, 133, and 27 patients had ERCP, MRC, and both, respectively. MRCP was positive in 30. ERCP was scheduled for these patients and performed in 24. In the remainder ERCP was not performed for the following reasons; 2 declined, 2 cancelled, 1 ERCP failed, and 1 had surgery. The positive predictive value of MRC was 91.7%. Three patients with a negative MRC had a subsequent ERCP (for clinical indications) and all were negative. The number of patients with a negative MRC later admitted with biliary disease was 6. Five had a cholecystectomy for gall stones, (3 emergency, 2 elective) and 1 declined to have follow up. One had pancreatitis while awaiting surgery. None of the patients who underwent surgery had bile stones at operation. Five patients have had persistent or recurrent symptoms; 1 was found to have pancreas divisum and 4 patients continue to have upper abdominal pain which appears musculoskeletal after further investigation. Three patients have died due to unrelated causes. The complications of ERCP were pancreatitis in 4 cases out of 229 (2 mild, 2 moderate), a minor bleed in 1 case...
ACCESSION #
9747426

 

Related Articles

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics