title: Cystic duct with no visible signal on magnetic resonance cholangiography is associated with laparoscopic difficulties: an analysis of 695 cases.
abstract: OBJECTIVE
  We investigated the association between the magnetic resonance cholangiography (MRC) results and surgical difficulties and bile duct injuries during laparoscopic cholecystectomy (LC).
  
  
  METHODS
  MRC was performed on 695 consecutive patients before LC. We divided the patients into two groups (visible cystic duct group and "no signal" cystic duct on MRC group) and compared them with regard to the length of the operation, conversion rate to open cholecystectomy (OC) and rate of bile duct injury.
  
  
  RESULTS
  The "no signal" cystic duct on MRC group had a longer operation and higher rate of conversion to OC compared with the visible cystic duct group. However, there was no statistically significant difference in the occurrence rate of bile duct injury between the two groups.
  
  
  CONCLUSIONS
  The "no signal" cystic duct on MRC group was associated with laparoscopic difficulties, but not with an increased rate of biliary injury. When a visible cystic duct is not observed on MRC an early conversion to open surgery may avoid a bile duct injury during LC.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Tama Medical Hospital, Tokyo, Japan, shimizu-yasu@umin.ac.jp.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Taiichi
authors.initials: T
authors.lastname: Otani
authors.forename: Jun
authors.initials: J
authors.lastname: Matsumoto
authors.forename: Kijuro
authors.initials: K
authors.lastname: Takanishi
authors.forename: Tomohito
authors.initials: T
authors.lastname: Minami
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsunoda
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000293:injuries*; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy / Q000379:methods / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D003549:Cystic Duct / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D013997:Time Factors
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