Inpatient magnetic resonance cholangiopancreatography: does it increase the efficiency in emergency hepatopancreaticobiliary surgery services?

Milburn, James; Bailey, James A.; Dunn, W. Keith; Cameron, Iain C.; Gomez, Dhanny

doi:10.1308/rcsann.2016.0291

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…MRCP can clearly display the image of the "biliary tree" and obtain the effect similar to direct cholangiography that the surgeon wants to know. At the same time, MRCP can accurately show the image information such as the size, number, location of the bile duct stones and the degree of biliary tract dilatation [24,25]. Many patients in our study bene ted from MRCP examination.…”

Section: Discussionmentioning

confidence: 81%

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Guo,

Fan,

Guo

et al. 2023

Preprint

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Background: In the past quite a long time, intraoperative cholangiography（IOC）was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patientsundergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. Methods: According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. Results: Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCPwere higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in non-MRCP group (8.43%) was significantly higher (P < 0.05) than that in MRCP group (0%). There was no significant difference in hospital stay (P > 0.05), but there was significant difference in hospitalization expenses (P < 0.05) between the two groups. According to the stratification of gallbladder stone patients with CBDS, hospital stay and hospitalization expenses were compared, and there was no significant difference between the two groups (P > 0.05). Conclusions: The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.

show abstract

Section: Discussionmentioning

confidence: 81%

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Guo,

Fan,

Guo

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…MRCP can clearly display the image of the “biliary tree” and obtain the effect similar to direct cholangiography that the surgeon wants to know. At the same time, MRCP can accurately show the image information such as the size, number, location of the bile duct stones and the degree of biliary tract dilatation [ 25 , 26 ]. For solitary stones or CBDS smaller than 6 mm detected by MRCP, they can spontaneously pass from the common bile duct into the duodenum.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Guo,

Fan,

Guo

et al. 2024

BMC Gastroenterol

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Background In the past quite a long time, intraoperative cholangiography(IOC)was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patients undergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. Methods According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. Results Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCP were higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in non-MRCP group (8.43%) was significantly higher (P < 0.05) than that in MRCP group (0%). There was no significant difference in hospital stay (P > 0.05), but there was significant difference in hospitalization expenses (P < 0.05) between the two groups. According to the stratification of gallbladder stone patients with CBDS, hospital stay and hospitalization expenses were compared, and there was no significant difference between the two groups (P > 0.05). Conclusions The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.

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“…MRCP reproduces the anatomical structure of the biliary tract, such as the opening position of the cystic duct and the relationship of the gallbladder triangle. Both sensitivity and speci city of MRCP in the diagnosis of gallbladder and bile duct diseases can reach more than 90% [21,22]. MRCP can accurately identify the size, number and location of bile duct stones and the degree of bile-pancreatic duct dilatation.…”

Section: Discussionmentioning

confidence: 99%

Routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy in patients with cholecystolithiasis

Guo,

Fan,

Wang

et al. 2023

Preprint

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Objective To demonstrate if patients with cholecystolithiasis at low risk of common bile duct stones (CBDS) require magnetic resonance cholangiopancreatography (MRCP) before laparoscopic cholecystectomy (LC). This study investigated the clinical value of routine MRCP before LC in patients with gallstones. Methods We adopted a non-randomized controlled experiment according to whether MRCP performed prior to LC, 277 patients with cholecystolithiasis at low risk of CBDS were divided into two groups:142 patients in the control group only underwent abdominal ultrasound, while 135 patients in the experimental group underwent both abdominal ultrasound and MRCP. The results of laboratory test, abdominal ultrasound and MRCP, surgical complications, length of stay and hospitalization costs were compared between the two groups. Result The detection rates of CBDS, cystic duct stones, gallbladder adenomyomatosis and anatomical variants of biliary tract by preoperative MRCP were higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group (0% vs. 5.63%, P < 0.05). The length of stay in the experimental group was shorter than that in the control group (P < 0.05). Conclusion Routine MRCP before LC can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by ultrasound. MRCP helps surgeons better understand the anatomical variation of extrahepatic bile duct, plan the operation rationally and efficiently reduce the occurrence of postoperative complications. Moreover, MRCP shorten the length of stay without increasing the hospitalization costs.

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Inpatient magnetic resonance cholangiopancreatography: does it increase the efficiency in emergency hepatopancreaticobiliary surgery services?

Cited by 4 publications

References 28 publications

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

Routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy in patients with cholecystolithiasis

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