title: Preoperative assessment for feasibility of laparoscopic cholecystectomy using magnetic resonance cholangiography.
abstract: OBJECTIVE
  We present the results of classification of magnetic resonance cholangiography (MRC) focusing upon visualization of cystic duct for preoperative laparoscopic cholecystectomy (LC), along with assessments of a possible correlation between MRC classification and feasibility of LC.
  
  
  METHODS
  The study included a total of 663 patients who were diagnosed as cholelithiasis. MRC were classified into four types: Type A; entire biliary tract was visualized (+), Type B; cystic duct (+) but gallbladder was not(-), Type C; gallbladder (+), cystic duct (-), and Type D; gallbladder (-), cystic duct (-). The feasibility of LC was assessed using the following two variables: 1) percentages of cases in which LC was changed to open cholecystectomy (OC) and 2) operating time. The results were compared in respect of the relationship with the MRC classification.
  
  
  RESULTS
  MRC were classified as follows: Type A (58.4%), Type B (15.2%), Type C (19.3%) and Type D (7.1%). A total of 124 patients (18.7%) had chronic cholecystitis, and a strong correlation with MRC type was noted (p<0.0001). In 46 patients (7.5%), the surgical procedure was changed from LC to OC. The percentages of cases in which LC was changed to OC was significantly higher for Type C and Type D (p<0.0001), so these two groups demonstrated prolonged operating time.
  
  
  CONCLUSIONS
  Our MRC classification based on the visualization of cystic duct can reflect the feasibility of LC, and LC may be less feasible tin Type C, and in particular Type D patients.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Dal Ho
authors.initials: DH
authors.lastname: Kim
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inose
authors.forename: Masaki
authors.initials: M
authors.lastname: Aizawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Masuda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography / Q000145:classification*; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery; D002908:Chronic Disease; D003549:Cystic Duct / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055815:Young Adult