The potential impact of high-quality MRI of the biliary tree on ERCP workload

Ar, Tanner; Dwarakanath, AD; Np, Tait

doi:10.1097/00042737-200012070-00010

Cited by 15 publications

(7 citation statements)

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“…Further investigations have attempted to estimate the potential impact of MRC as a diagnostic modality. It has been proposed that if MRC is available with accurate test performance features, up to 40% of patients with clinically suspected biliary tract disease could avoid diagnostic ERCP and less than 10% would require both MRC and ERCP 23, 24. These findings may have significant implications in clinical practice settings in which the prevalence of PSC is lower than what is observed in referral‐based centers.…”

Section: Discussionmentioning

confidence: 99%

Cost-minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis

et al. 2004

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Investigations examining the use of magnetic resonance cholangiography (MRC) for the diagnosis of primary sclerosing cholangitis (PSC) have described comparable accuracy when compared to endoscopic retrograde cholangiopancreatography (ERCP). The effectiveness of MRC based on overall cost, however, remains unknown. Our aim was to determine the average cost per correct diagnosis using MRC or ERCP as the initial testing strategy for the diagnosis of PSC. A decision analysis model was constructed employing diagnostic test parameters prospectively determined among 73 patients with clinically suspected biliary disease. ERCP was performed within 24 hours after MRC. Cost data were derived from average Medicare reimbursement fee schedules. The prevalence of PSC in the study cohort was 32%. The sensitivity and specificity of MRC for the diagnosis of PSC were 82% and 98%, respectively. The average cost per correct diagnosis of PSC was $724.

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Section: Discussionmentioning

confidence: 99%

Cost-minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis

et al. 2004

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“…17 The results are very dependent on the skills of the team involved. 19 ERCP is currently the 'gold standard' for the diagnosis of pancreatic and biliary ductal pathology. 20 Approximately 10% of ERCPs performed are unsuccessful, approximately 15% will demonstrate normal results and many will demonstrate abnormalities that do not require further endoscopic therapy.…”

Section: Ercpmentioning

confidence: 99%

A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography

Kaltenthaler

Vergel²,

Chilcott³

et al. 2004

Health Technol Assess

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“…MRCP has an added advantage in situations where ERCP has failed or cannot be performed 58,59 , while ERCP has the advantage that ductal stones, if detected, can be removed at the time of examination and a sphincterotomy performed. However, for diagnostic purposes several authors have suggested that MRCP should replace ERCP as the initial investigation of choice 53,54,60 .…”

Section: Magnetic Resonance Cholangiopancreatographymentioning

confidence: 99%

Management of severe acute pancreatitis

Yousaf

McCallion

Diamond

2003

British Journal of Surgery

138

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Recent evidence has helped to clarify the roles of computed tomography, endoscopic retrograde cholangiopancreatography, prophylactic antibiotics, enteral feeding and fine-needle aspiration for bacteriology in the management of acute pancreatitis. Despite a relative shortage of prospective randomized trials there has been a significant change in the surgical management of acute pancreatitis over the past 20 years. This change has been away from early aggressive surgical intervention towards more conservative management, except when infected necrosis is confirmed. A formalized approach, with appropriate use of the various non-surgical and surgical options, is feasible in the management of severe acute pancreatitis.

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The potential impact of high-quality MRI of the biliary tree on ERCP workload

Cited by 15 publications

References 0 publications

Cost-minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis

Cost-minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis

A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography

Management of severe acute pancreatitis

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