scholarly journals Imaging of common bile duct stones

2016 ◽  
Vol 28 (1) ◽  
pp. 59-68
Author(s):  
A Nurman A Nurman
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Mr Imaging ◽  
Imaging Techniques ◽  
Gallbladder Disease ◽  
Acute Cholangitis ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Gastrointestinal Diseases

The gallbladder serves as the repository for bile produced in the liver. However, bile within the gallbladder may become supersaturated with cholesterol, leading to crystal precipitation and subsequent gallstone formation. Gallstone is one of the most common gastrointestinal diseases in clinical practice. Common bile duct stone may be silent and symptomless; alternatively the stone can cause acute cholangitis with jaundice, pain and fever and acute pancreatitis. Imaging of the gallbladder is typically requested for evaluation of right upper quadrant pain in patients with or without fever and jaundice. Hence,imaging is central to the investigation and diagnoses of choledocholithiasis. There are many options in the field of imaging of choledocholithiasis from a simple to more sophisticated examinations. Ultrasonography (US) has been the traditional modality for evaluating gallbladder disease, primarily owing to its high sensitivity and specificity for both stone disease and gallbladder inflammation. However, US is limited by patient body habitus, with degradation of image quality and anatomic detail in obese individuals. With the advent of faster and more efficient imaging techniques, magnetic resonance (MR) imaging has assumed an increasing role as an adjunct modality for gallbladder imaging. MR imaging allows simultaneous anatomic and physiologic assessment of the gallbladder and biliary tract. Magnetic resonance cholangiopancreatography is excellent for identifying the presence and the level of biliary obstruction. With newer diagnostic imaging technologies emerging, endoscopic retrograde cholangiopancreatography is evolving into a predominantly therapeutic procedure.

scholarly journals Accuracy of Ultrasound and Magnetic Resonance Cholangiopancreatography Findings in the Diagnosis of Biliary System Stones

2022 ◽  
Vol 30 (1) ◽  
pp. 841-852
Author(s):  
Abdullah Taher Naji ◽  
Ameen Mohsen Amer ◽  
Saddam Mohammed Alzofi ◽  
Esmail Abdu Ali ◽  
Noman Qaid Alnaggar
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Final Diagnosis ◽  
Biliary System ◽  
Cbd Stones ◽  
System Diagnosis ◽  
Us Findings

This study aimed to evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) and Ultrasound (US) images for the diagnosis of biliary system stones, as well as to assess the consistency between MRCP and US findings. The study sample included 200 cases (90 males and 110 females) with symptomatic biliary system stones between 14 and 82 years. All cases underwent both the US and MRCP imaging for biliary system diagnosis. The study revealed that the most prominent age group with symptoms of biliary system stones was the 33-60-year-old group. It also found that the accuracy of US and MRCP in detecting gallbladder (GB) stones compared with the final diagnosis was 94% and 91%, respectively, with moderate conformity between their results. The accuracy of US and MRCP images in detecting common bile duct (CBD) stones was 61% and 98%, respectively, with fair conformity between their results. In addition, there is a significant agreement between the MRCP and US results in detecting the GB and CBD stones with an agreed percentage of 74% and 71%, respectively. The study concluded that US is the preferred imaging technique for patients with symptomatic gallbladder stones, whereas MRCP is a trustworthy investigation for common bile duct 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

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.

scholarly journals Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit

2020 ◽  
Vol 102 (8) ◽  
pp. 598-600
Author(s):  
S Donoghue ◽  
RM Jones ◽  
A Bush ◽  
G Srinivas ◽  
K Bowling ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Laparoscopic Ultrasound ◽  
Bile Duct Stones ◽  
Symptomatic Gallstones ◽  
Bed Days ◽  
The Cost

Introduction Common bile duct stones are present in 10% of patients with symptomatic gallstones. One-third of UK patients undergoing cholecystectomy will have preoperative ductal imaging, commonly with magnetic resonance cholangiopancreatography. Intraoperative laparoscopic ultrasound is a valid alternative but is not widely used. The primary aim of this study was to assess cost effectiveness of laparoscopic ultrasound compared with magnetic resonance cholangiopancreatography. Materials and methods A prospective database of all patients undergoing laparoscopic cholecystectomy between 2015 and 2018 at a district general hospital was assessed. Inclusion criteria were all patients, emergency and elective, with symptomatic gallstones and suspicion of common bile duct stones (derangement of liver function tests with or without dilated common bile duct on preoperative ultrasound, or history of pancreatitis). Patients with known common bile duct stones (magnetic resonance cholangiopancreatography or failed endoscopic retrograde cholangiogram) were excluded. Ninety-day morbidity data were also collected. Results A total of 420 (334 elective and 86 emergency) patients were suspected to have common bile duct stones and were included in the study. The cost of a laparoscopic ultrasound was £183 per use. The cost of using the magnetic resonance cholangiopancreatography unit was £365 per use. Ten postoperative magnetic resonance cholangiopancreatographies were performed for inconclusive intraoperative imaging. The estimated cost saving was £74,650. Some 128 patients had common bile duct stones detected intraoperatively and treated. There was a false positive rate of 4.7%, and the false negative rate at 90 days was 0.7%. laparoscopic ultrasound use saved 129 bed days for emergency patients and 240 magnetic resonance cholangiopancreatography hours of magnetic resonance imaging. Conclusion The use of laparoscopic ultrasound during laparoscopic cholecystectomy for the detection of common bile duct stone is safe, accurate and cost effective. Equipment and maintenance costs are quickly offset and hospital bed days can be saved with its use.

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