Accuracy of Abbreviated Protocol of Magnetic Resonance Cholangio-Pancreatography in the Diagnosis of Choledocholithiasis

AGOSTINI, Ângela de Figueiredo Pinto; Hochhegger, Bruno; Forte, Gabriele Carra; SUSIN, Luiza Aguirre; Difini, João Pedro Miranda

doi:10.1590/s0004-2803.202202000-35

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Furthermore, a study has indicated that MRCP sensitivity, specificity, and accuracy goes up when stones size gets larger and higher contrast resolution are used in diagnosing the choledocholithiasis. 15 This study has shown that although the sensitivity, specificity, and accuracy of the MRCP are less than ERCP, however, MRCP could be a good alternative to ERCP in patients with choledocholithiasis being noninvasive.…”

Section: Discussionmentioning

confidence: 83%

Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis

Shahid¹,

Fatima²,

Ahmed³

et al. 2022

AJHMN

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Background: Various imaging modalities including EUS (Endoscopic ultrasound), CT abdomen (Computed tomography), MRCP (Magnetic resonance cholangiopancreatography), and ERCP (Endoscopic retrograde cholangiopancreatography) are used for diagnosis of choledocholithiasis. ERCP allows direct visualization of bile duct through endoscope, and it also helps in retrieval of stones. On the other hand, MRCP is a noninvasive procedure which uses strong magnetic field to visualize hepatobiliary system. In patients with choledocholithiasis calculi appear as dark filling defects within high signal intensity fluid at MRCP. This study compares the diagnostic accuracy of MRCP in comparison to ERCP in patients with choledocholithiasis. This study aims to compare sensitivity and specificity of MRCP in comparison to ERCP in diagnosing choledocholithiasis. Methodology: This comparative cross-sectional study included 170 patients with clinical diagnosis of choledocholithiasis who presented in Liver Center, Holy Family Hospital, Rawalpindi, during the year 2017. Non-probability consecutive sampling technique and a set of established inclusion and exclusion criteria was used to enroll patients. Data was collected by a self-structured questionnaire. Information about the demographic details and findings of ERCP and MRCP were noted on that questionnaire. Data analysis was done using SPSS 25. Results: Out of 170 patients, 111 (65.29%) were females and 59 (34.71%) were males. The mean of age for study population was 45.68 with standard deviation (SD) of ±12.40. ERCP confirmed stones in 95 patients while in case of MRCP 87 true positives, 55 true negatives, 20 false positives, and 8 false negatives cases were noted. According to these results, the sensitivity and specificity were 91.6% and 73.3% respectively for MRCP against ERCP. Whereas positive predictive value and negative predictive values were 81.3 and 87.3% respectively for MRCP in comparison to ERCP. Conclusion: MRCP has 91.6% sensitivity compared to ERCP. Although MRCP is a comparatively noninvasive procedure, but ERCP remains the diagnostic modality of choice for choledocholithiasis. MRCP could be used in diagnosis of choledocholithiasis instead of ERCP when there are contraindications of ERCP or when no therapeutic role of ERCP is required. Recommendations: MRCP should be used when only diagnostic role of ERCP is needed. MRCP should be used when there are contraindications of ERCP. Level of expertise should be increased for MRCP and ERCP.

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Section: Discussionmentioning

confidence: 83%

Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis

Shahid¹,

Fatima²,

Ahmed³

et al. 2022

AJHMN

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“…Magnetic resonance cholangiopancreatography (MRCP) is highly sensitive and specific in detecting choledocholithiasis. The efficiency of MRCP is comparable to invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and intraoperative cholangiography (IOC) [ 12 ]. ERCP has both diagnostic and therapeutic functions, but it can lead to pancreatitis, cholangitis, perforation of organs, or bleeding [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

et al. 2022

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Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in children and compare them with the treatment outcomes of previously used endoscopic retrograde cholangiopancreatography (ERCP). Methods: From January 2000 to January 2022, a total of 84 children (78.5% female) underwent laparoscopic cholecystectomy with a median follow-up of 11.4 (IQR 8, 14) years. Of these, 6 children underwent laparoscopic cholecystectomy (LC) + ERCP and 14 children underwent LCBDE for choledochiothiasis. The primary end point of the study was the success of treatment in terms of the incidence of complications, recurrence rate, and rate of reoperation. Secondary endpoints were stone characteristics, presenting symptoms, duration of surgery, and length of hospital stay. Results: The majority of patients were female in both groups (83.5% vs. 85.7%), mostly overweight with a median BMI of 27.9 kg/m2 and 27.4 kg/m2, respectively. Obstructive jaundice, colicky pain, acute pancreatitis, and obstruction of the papilla were the most common symptoms in both groups. The majority of patients (68%) had one stone, whereas two or more stones were found in 32% of patients. The median diameter of the common bile duct was 9 mm in both groups. The procedure was successfully completed in all patients in the ERCP group. In the group of patients treated with LCBDE, endoscopic extraction of the stone with a Dormia basket was successfully performed in ten patients (71.4%), while in the remaining four patients (28.6%) the stones were fragmented with a laser because extraction with the Dormia basket was not possible. The median operative time was 79 min in the LCBDE group (IQR 68, 98), while it was slightly longer in the ERCP group, 85 min (IQR 74, 105) (p = 0.125). The length of hospital stay was significantly shorter in the LCBDE group (2 vs. 4 days, p = 0.011). No complications occurred in the LCBDE group, while two (40%) complications occurred in the ERCP group: pancreatitis and cholangitis (p = 0.078). During the follow-up period, no conversions, papillotomies, or recurrences were recorded in either group. Conclusions: Exploration of the common bile duct and removal of stones by LCBDE is safe and feasible in pediatric patients for the treatment of choledocholithiasis. Through this procedure, choledocholithiasis and cholelithiasis can be treated in a single procedure without papillotomy or fluoroscopy. Compared with LC + ERCP, LCBDE is associated with a shorter hospital stay. The incidence of complications was rather low but not statistically significant.

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Choledocholithiasis: Easy and Early Diagnosis

Sarmiento,

Himmler,

Gallegos

et al. 2023

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Accuracy of Abbreviated Protocol of Magnetic Resonance Cholangio-Pancreatography in the Diagnosis of Choledocholithiasis

Cited by 3 publications

References 18 publications

Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis

Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

Choledocholithiasis: Easy and Early Diagnosis

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