Routine magnetic resonance cholangiopancreatography and intra-operative cholangiogram in the evaluation of common bile duct stones

Ann R Coll Surg Engl. 2005 Nov;87(6):469-70. doi: 10.1308/003588405X51137.

Abstract

Introduction: Magnetic resonance cholangiopancreatography (MRCP) is a safe and sensitive investigation for the imaging of common bile duct pathology. When used to exclude common bile duct (CBD) stones, MRCP may obviate the need for intra-operative cholangiogram (IOC). In this prospective study, we looked at the single centre results of patients who underwent cholecystectomy with IOC following pre-operative MRCP.

Patients and methods: Over a period of 18 months, 69 patients (24 male and 45 female; mean age 59 years [range, 19-86 years]) were investigated by MRCP prior to cholecystectomy. All patients underwent IOC. Inclusion criteria for MRCP consisted of derangement of liver function tests and/or history of jaundice in cases of ultrasound-proven cholelithiasis.

Results: Sixteen patients had suspected stones or filling defects on MRCP; all but two of these were confirmed to be stones on IOC. In only one patient was a stone visualised on IOC and not seen on MRCP.

Conclusion: MRCP may be the only pre-operative investigation needed for exclusion of CBD stones, obviating the necessity for IOC.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cholangiography / methods
  • Cholangiopancreatography, Magnetic Resonance / methods*
  • Cholecystectomy / methods
  • Cholelithiasis / diagnosis*
  • Female
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity