Objective: To determine the diagnostic accuracy of magnetic-resonance-cholangio-pancreatography (MRCP) in diagnosis of obstructive biliopathy in comparison to endoscopic retrograde cholangio-pancreatography (ERCP) taking as gold standard. Study design: It is a cross sectional study. Place and duration of study: Study was conducted on the patients admitted in the gastroenterology department of Sir Ganga Ram Hospital Lahore. Study was completed in six months duration from January 2022 to June 2022. Methodology: Patients with the suspicion of obstructive biliopathies requiring ERCP were included in this study. Study sample was divided into two groups, in one group ERCP was done while other group underwent MRCP. Resulst of both techniques were reviewed by radiologist and gastroenterologist and compared with each other considering ERCP as gold standard. P-value <0.05 was considered statistically significance. Confidence interval was 95%. Results: Total 130 cases were divided into two groups with equal number of 65 patients in each. There were 75(57.6%) female and 55(42.3%) male cases. Mean age of the patients was 43.7± 3.5 years. Sensitivity of MRCP for obstructive biliopathies was 92.4%, specificity 90.7%, positive predictive value 88.3% and negative predictive value 89.2%. Conclusion: MRCP is a non-invasive investigation of choice in obstructive biliopathies having high diagnostic accuracy avoiding unnecessary complications of ERCPs. Keywords: MRCP, ERCP, Obstructive Biliopathy, CBD Stone, Stricture
Objective: To highlight the significance of endoscopic retrograde cholangio-pancreatography, its indications, findings and complications. Material and methods: This is a prospective study conducted on the patients admitted in the gastroenterology department of Sir Ganga Ram Hospital Lahore. Study period was of six months from July 2021 to December 2021. Main outcomes in this study were technical safety, indications of ERCP and complications. Study sample was calculated using WHO sample size formula. Results: Total 200 cases were included in this study including 116 (58%) male and 84(42%) female. CBD cannulation was done in 184(192%) cases. CBD stone was found in 35(17.5%), CBD stricture in 44(22%) and CBD stricture with stone found in 17(8.5%) cases. 11(5.5%) cases developed acute pancreatitis out of which 2(01%) cases had severe pancreatitis with collection of fluid. One case (0.5%) had retroperitoneal perforation which was managed conservatively. 03(1.5%) cases had bleeding after the procedure and hemostasis achieved by re-scope with adrenal injection at the bleeding point. Conclusion: ERCP procedure has a high success rate with minimum complications. Keywords: ERCP, Findings, Complications, CBD stone, Pancreatitis
Objective: To study frequency of various types of gall stones extracted from bile duct using ERCP Study design: This is a cross sectional study Study place and duration: Study was conducted in the department of Gastroenterology Sir Ganga Ram Hospital Lahore. Study was completed in six months duration from January 2022 to June 2022. Materials and methods: Diagnosed cases of bile duct stones were underwent ERCP and extracted stones were analyzed to determine their composition. Ages of the patients were 20-70 years. Cases of either gender irrespective of residential area were included in this study. Patients with ischemic heart disease, asthma, liver cirrhosis, malignancy, tuberculosis, chronic obstructive pulmonary disease, interstitial lung disease and pregnancy were excluded from the study. During ERCP gross findings of the stones were noted. Results: Total 140 cases were studied having bile duct stones including 55(39.3%) male and 85(60.7%) females. There were 80(57%) cases with the age ≤50 years and 60(42.9%) cases above 50 years. Mean age of the patients was 46 ± 4.72 years. 58(41.4%) cases were from rural area and 82(58.6%) from urban area. Diabetes, hypertension and obesity was found in 38(27%), 47(33.6%) and 49(35%) cases respectively. Cholesterol stones were found in 51(36.4%), mixed stones in 70(50%) and brown pigmented stones in 19(13.6%) cases. Conclusion: Mixed cholesterol gall stones were most commonly found followed by pure cholesterol and brown pigmented stones. Keywords: Gallstones, Bile duct stones, ERCP, Endocscopy, Cholesterol stones,
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