Diagnostic value of magnetic resonance cholangiopancreatography to detect bile duct stones in acute biliary pancreatitis

Pancreatology ◽  
2014 ◽  
Vol 14 (3) ◽  
pp. S98
Author(s):  
Hyung-Keun Kim ◽  
Hyuk-Min Kwon ◽  
Young-Seok Cho ◽  
Sung-Soo Kim ◽  
Hiun-Suk Chae
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Diagnostic Value ◽  
Biliary Pancreatitis ◽  
Bile Duct Stones ◽  
Acute Biliary Pancreatitis

scholarly journals Detection of Common Bile Duct Stones in Mild Acute Biliary Pancreatitis Using Magnetic Resonance Cholangiopancreatography

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
David Aranovich ◽  
Veacheslav Zilbermints ◽  
Natalia Goldberg ◽  
Oleg Kaminsky
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Cbd Stones ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background. All patients with mild acute biliary pancreatitis should undergo early cholecystectomy. Whether routine common bile duct (CBD) imaging should be employed before the surgical procedure in these patients is a matter of current controversy. The aim of this study was to investigate the rate of detection of CBD stones using magnetic resonance cholangiopancreatography (MRCP) at different time intervals from admission. Methods. From January 1, 2011, through December 31, 2016, 72 patients with acute biliary pancreatitis underwent MRCP. Fifty-six (n=56) of them with mild biliary pancreatitis met the study criteria. The patients were divided into two groups. Group A did not have stones in the CBD (n=45), and Group B had stones in the CBD (n=11). The time from admission to MRCP was divided into several periods (day 1 through day 180), and the presence of the CBD stones on MRCP was weighted against remoteness from admission. Liver chemistry profiles were compared between the groups on admission and before the MRCP. Results. The cumulative rate of choledocholithiasis was 19.7% (Group B, n=11). Forty-five patients (Group A, n=45, 80.3%) did not have gallstones in the CBD. Eight patients with choledocholithiasis (8/56, 14.2%) were detected during the first 10 days from admission out of 27 patients. In patients who underwent MRCP between days 11 and 20, choledocholithiasis was found in two patients (2/56, 3.5%) and in one patient between days 21 and 30 (1/56, 1.8%). No stones were found in patients who underwent MRCP beyond 30 days from admission. Liver chemistry profiles did not show a significant difference in both groups. CBD dilatation was observed at presentation in 11 patients (n=11/56), 6 in Group A (6/45, 13.3%) and 5 in Group B (5/11, 45.5%) (p=0.016). Conclusions. Routine CBD evaluation should be encouraged after mild acute biliary pancreatitis. Early performance of MRCP gives high yield in selecting the patients for endoscopic retrograde cholangiopancreatography (ERCP) before cholecystectomy. A liver chemistry profile either on admission or before MRCP cannot predict the presence of CBD stones.

Contribution of magnetic resonance cholangiopancreatography to the management of patients with suspected common bile duct stones

2004 ◽  
Vol 28 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Guillaume Gautier ◽  
Frank Pilleul ◽  
Arielle Crombe-Ternamian ◽  
Laurent Gruner ◽  
Thierry Ponchon ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Bile Duct Stones

scholarly journals Presence of choledocholithiasis in patients undergoing cholecystectomy for mild biliary pancreatitis

2016 ◽  
Vol 15 (4) ◽  
pp. 517-521
Author(s):  
Sumita Pradhan ◽  
JN Shah
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Medical Science ◽  
Common Bile Duct Stones ◽  
Biliary Pancreatitis ◽  
Bile Duct Stones ◽  
Acute Biliary Pancreatitis ◽  
The Common

Background: Standard recommendations for patients recovering from an episode of biliary pancreatitis include cholecystectomy with intra operative cholangiogram or ERCP during the same hospital admission as it is believed that the instigating factor is the passage of stones through the common bile duct. As ERCP is not widely available and expensive, cholecystectomy with IOC is routinely performed to rule out choledocholithiasis. However detection of common bile duct stones is challenging. Whether these patients undergoing cholecystectomy require direct common bile duct evaluation is controversial.Objectives: To see the presence of common bile duct stones in patients with resolving acute mild biliary pancreatitis.Materials and Methods: Patients admitted in the surgical ward in Patan and Bir hospital with the diagnosis of mild acute biliary pancreatitis that underwent cholecystectomy with intra operative cholangiography from August 2010 to July 2011 were studied. The outcome of cholangiogram was analyzed together with findings of Common bile duct exploration.Result and Conclusion: A total of 52 patients with acute mild biliary pancreatitis were operated during this period. The Common bile duct stone was found in 1.9%. Out of four patients with abnormal cholangiogram, only one patient (25%) had stone on exploration, rest of the three cases (75%) had negative exploration. The presence of common bile duct stone in case of mild acute biliary pancreatitis undergoing cholecystectomy is very low (1.96%), and thus policy of selective IOC should be applied for cases with mild biliary pancreatitis.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.517-521

The Role of Magnetic Resonance Cholangiopancreatography in the Diagnosis of Choledocholithiasis: Do Benefits Outweigh the Costs?

2015 ◽  
Vol 81 (7) ◽  
pp. 720-725 ◽  
Author(s):  
William H. Ward ◽  
Laura M. Fluke ◽  
Benjamin D. Hoagland ◽  
Gregory J. Zarow ◽  
Jenny M. Held ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Length Of Stay ◽  
Common Bile Duct ◽  
Predictive Value ◽  
Demographic Data ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Bile Duct Stones

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard in evaluation of the biliary tree for choledocholithiasis. Formal indications for magnetic resonance cholangiopancreatography (MRCP) in suspected choledocholithiasis are lacking. Our objective was to determine if MRCP affects management of patients who otherwise would undergo ERCP. A review was conducted of all MRCPs and ERCPs at our institution from 2008 to 2012 with suspected choledocholithiasis. Patients who underwent MRCP and ERCP were compared with those who underwent ERCP alone. Demographic data were collected and notation of whether a post-MRCP ERCP occurred was the primary variable. MRCP was performed in 107 patients for choledocholithiasis. Eighty-eight patients were negative for choledocholithiasis (82%) and 76 were discharged without ERCP (71%). Thirty-one patients received a diagnosis of choledocholithiasis and were referred for ERCP. Of the 19 patients with MRCP-diagnosed common bile duct stones, 95 per cent were confirmed by ERCP (odds ratio 18.0, P > 0.05; agreement 77%, sensitivity 0.76, specificity 0.86, positive predictive value 0.95, negative predictive value 0.50). Length of stay was similar for all groups. A total of 131 patients underwent ERCP without a preprocedural MRCP. Choledocholithiasis was found in 116 patients (92%), whereas 12 patients (9%) had no common bile duct stones and three had an alternate diagnosis. In conclusion, MRCP significantly affected the management of patients who would have undergone ERCP. MRCP did not increase length of stay and contributed to the 95 per cent positivity rate of subsequent ERCPs. These data illustrate the utility of MRCP in suspected choledocholithiasis patients at a low cost with regard to risk and time.

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