Magnetic Resonance Cholangio-Pancreatography in Patients with Acute Cholecystitis and Cholestatic Liver Pattern - What to Expect?

Orf, Ali Al; Waheed, Khawaja Bilal; Alshehri, Ali Salman; Algarni, Mushref Ali; Altaf, Bilal; Amjad, Muhammad; Alhumaid, Ayman Abdullah; Arulanantham, Zechariah Jebakumar

doi:10.14260/jemds/2020/530

Cited by 1 publication

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“…Another retrospective study by Fayad et al (2003) showed that functional method of MRCP increased the diagnostic yield of AC when combined with conventional MRCP method, where the positive predictive value was 100% [13]. In addition, a recent study by Orf et al (2020) revealed that MRCP could differentiate AC patients with normal CBD caliber, dilated CBD, the cause, and associated anomalies [14]. However, several conditions, such as uncooperative patients, elderly patients, and claustrophobia patients are becoming the major concern.…”

Section: Acute Cholecystitis Diagnosis and The Role Of Endoscopic Ultrasoundmentioning

confidence: 99%

The Role of Endoscopic Ultrasound in Acute Cholecystitis

Lesmana¹,

Lesmana²

2022

Gallstones - Review and Recent Progress

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Acute cholecystitis (AC) is one of challenging clinical conditions in biliary disorders as it can carry high morbidity and mortality. Gallstone disease is still the main cause of AC in clinical practice. Transabdominal ultrasound, abdominal CT scan and abdominal MRI are the standard diagnostic tools in AC, however, some obstacles can be found which are associated to the patient’s factor, anatomy or anomaly of biliary system, the disease severity, and the operator. Cholecystectomy is still the primary choice management in AC condition, however, several issues need to be encountered, such as critically ill condition, sepsis, and patient’s comorbidity. Percutaneous approach has become an alternative as it is considered as a simple procedure to be performed in clinical practice. Catheter dislodgement, the risk of bile leakage, and uncooperative patients have raised major concerns for this procedure. Another method, such as endoscopic approach has been studied as well and it seemed to have more advantage when compared to the percutaneous approach. Recently, endoscopic ultrasound (EUS) has been used as a combined diagnostic as well as therapeutic tools in managing biliary disorders. Recent evidences about the role of EUS approach for gallbladder drainage (EUS GBD) in patients who unsuitable for surgery have emerged in the past one decade. However, comprehensive evaluation before which approach is the best option is needed as expertise, cost, and patient’s outcome prediction are the most important factors to be considered in the real clinical practice.

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