title: Inpatient magnetic resonance cholangiopancreatography: does it increase the efficiency in emergency hepatopancreaticobiliary surgery services?
abstract: INTRODUCTION Magnetic resonance cholangiopancreatography (MRCP) is commonly used to evaluate the biliary tree, although indications for patients who require inpatient imaging are not fully defined. The aim of this study was to evaluate inpatient MRCP performed on surgical patients and to devise a treatment pathway for these patients. MATERIAL AND METHODS All adult inpatient MRCP examinations between January 2012 and December 2013 were reviewed. Demographic, clinical and radiological data were collated. RESULTS During the study period, 271 inpatient MRCP were requested, of which 234 examinations were included. The majority of patients were female (n=140) and the median age was 63 years (range 16-93 years). Surgical admissions accounted for 171 (73%) of cases. Indications for inpatient MRCP include gallstone-related complications (n=173; 74%), malignant process (n=17; 7%) and other indications (n=44; 19%). Overall, inpatient MRCP led to further inpatient interventions in 22% (gallstone group, n=32, 18%; patients with malignancy, n=8, 47%; other indications, n=12, 27%). The median duration of inpatient MRCP from request to examination was 2 days (range 0-15 days) and median reporting after examination was 1 day (range 0-14 days). DISCUSSION AND CONCLUSION Improved access and timely reporting of iMRCP may reduce length of hospital stay. Inpatient MRCP also led to further inpatient interventions, in particular, in patients with malignancy.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust , Nottingham , UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Milburn
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust , Nottingham , UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Bailey
authors.affiliation: Department of Radiology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust , Nottingham , UK.
authors.forename: Wk
authors.initials: W
authors.lastname: Dunn
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust , Nottingham , UK.
authors.forename: I C
authors.initials: IC
authors.lastname: Cameron
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust , Nottingham , UK.|NIHR Nottingham Digestive Disease Biomedical research Unit, University of Nottingham , Nottingham , UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Gomez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D049448:Cholangiopancreatography, Magnetic Resonance; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000601:surgery; D017598:Efficiency, Organizational; D005260:Female; D006760:Hospitalization; D006801:Humans; D018285:Klatskin Tumor / Q000000981:diagnostic imaging* / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013503:Surgery Department, Hospital; D055815:Young Adult
keywords: Choledocholithiasis; Cholelithiasis; Magnetic resonance cholangiopancreatography