Routine magnetic resonance cholangiopancreatography and intra-operative cholangiogram in the evaluation of common bile duct stones.
BACKGROUND
Magnetic resonance cholangiopancreatography (MRCP) is a safe and sensitive investigation for the imaging of common bile duct pathology. When used to exclude common bile duct (CBD) stones, MRCP may obviate the need for intra-operative cholangiogram (IOC). In this prospective study, we looked at the single centre results of patients who underwent cholecystectomy with IOC following pre-operative MRCP.


METHODS
Over a period of 18 months, 69 patients (24 male and 45 female; mean age 59 years [range, 19-86 years]) were investigated by MRCP prior to cholecystectomy. All patients underwent IOC. Inclusion criteria for MRCP consisted of derangement of liver function tests and/or history of jaundice in cases of ultrasound-proven cholelithiasis.


RESULTS
Sixteen patients had suspected stones or filling defects on MRCP; all but two of these were confirmed to be stones on IOC. In only one patient was a stone visualised on IOC and not seen on MRCP.


CONCLUSIONS
MRCP may be the only pre-operative investigation needed for exclusion of CBD stones, obviating the necessity for IOC.
Dalton
S J
SJ
Churchill Building, University of Bristol, Bristol, UK. S.J.Dalton@bristol.ac.uk
Balupuri
S
S
Guest
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002758:Cholangiography / Q000379:methods; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D002763:Cholecystectomy / Q000379:methods; D002769:Cholelithiasis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity