Impact of magnetic resonance cholangiography on endoscopic therapy before and after laparoscopic cholecystectomy.
OBJECTIVE
To assess the impact of magnetic resonance cholangiography (MRC) on endoscopic therapy before and after laparoscopic cholecystectomy (LC).


METHODS
Ninety-six patients were referred for endoscopic retrograde cholangiography (ERC) before or after LC because of abnormal liver function tests, raised serum amylase, or abnormal ultrasound scan (USS) of the biliary system. All patients underwent MRC before ERC.


RESULTS
Common bile duct (CBD) stones were detected in 48 patients on ERC, 40 on MRC, and 23 on USS. The CBD was dilated on ERC (> 8 mm) in 59 patients, on MRC (> 7 mm) in 51, and on USS (> 7 mm) in 42. Abnormal CBD (dilated +/- stone) was detected in 69 patients on ERC, 57 on MRC, and 44 on USS. Intrahepatic ducts were dilated on ERC in 26 patients, on MRC in 24, and on USS in 18. The study was abnormal on ERC in 81 patients, on MRC in 63, and on USS in 51. Endoscopic therapy was attempted in 80 patients. Presence of CBD stone (p = 0.03), dilated CBD (p = 0.01), abnormal CBD (p = 0.0007), and abnormal study (p = 0.0004) on MRC were significantly related to endoscopic therapy. In 6 cases LC was deferred because MRC revealed CBD calculi which could not be cleared endoscopically. ERC could have been avoided in 14/ 19 patients who did not benefit from it.


CONCLUSIONS
MRC findings are significantly related to endoscopic therapy in patients referred for ERC before and after LC, and they influence therapeutic decisions in some of them.
Contractor
Qais Qutub
QQ
Department of Internal Medicine, King Fahad Specialist Hospital, P O Box 2290, Buraidah, Gassim, Kingdom of Saudi Arabia. drqaisqc@hotmail.com
Karkaria
Anupam Kumar
AK
Contractor
Tasneem Qais
TQ
Dubian
Mohammed Kheir
MK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D003135:Common Bile Duct / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies