The Detection of Bile Duct Stones in Suspected Biliary Pancreatitis: Comparison of MRCP, ERCP, and Intraductal US

Moon, Jong Ho; Cho, Young Deok; Woo, Seung Kyoon; Cheon, Young Koog; Ahn, Hyun Cheol; Kim, Young Seok; Kim, Yun Soo; Lee, Joon Seong; Lee, Moon Sung; Lee, Hae Kyung; Shim, Chan Sup; Kim, Boo Sung

doi:10.1111/j.1572-0241.2005.41057.x

Cited by 189 publications

(116 citation statements)

References 30 publications

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“…Unfortunately, its performance in detecting CBD stones is disappointing, with a reported sensitivity of only 25% to 58% and a specificity of 68% to 91% [66]. The sensitivity of the CT scan for detecting CBD stones is about 40%, which is too low for it to be of clinical use [67]. However, MRCP is a very accurate method detecting CBD stones, with a reported sensitivity of 82% to 95%, a specificity of 97.5% to100%, a positive predictive value of 95% to100%, and a negative predictive value of 90% to 98% [33,[68][69][70][71][72][73].…”

Section: Endoscopic Sphincterotomy Versus Conservative Managementmentioning

confidence: 99%

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

et al. 2009

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Background Recurrent attacks of acute biliary pancreatitis (RABP) are prevented by (laparoscopic) cholecystectomy. Since the introduction of endoscopic retrograde cholangiopancreaticography (ERCP), several series have described a similar reduction of RABP after endoscopic sphincterotomy (ES). This report discusses the different treatment options for preventing RABP including conservative treatment, cholecystectomy, ES, and combinations of these options as well as their respective timing. Methods A search in PubMed for observational studies and clinical (comparative) trials published in the English language was performed on the subject of recurrent acute biliary pancreatitis and other gallstone complications after an initial attack of acute pancreatitis. Result Cholecystectomy and ES both are superior to conservative treatment in reducing the incidence of RABP. Cholecystectomy provides additional protection for gallstone-related complications and mortality. Observational studies indicate that cholecystectomy combined with ES is the most effective treatment for reducing the incidence of RABP attacks.Conclusion From the literature data it can be concluded that ES is as effective in reducing RABP as cholecystectomy but inferior in reducing mortality and overall morbidity. The combination of ES and cholecystectomy seems superior to either of the treatment methods alone. A prospective randomized clinical trial comparing ES plus cholecystectomy with cholecystectomy alone is needed.Keywords Acute biliary pancreatitis Á Cholecystectomy Á Endoscopic sphincterotomy Á ERCP Á Recurrent Acute biliary or gallstone pancreatitis (ABP) is an inflammatory condition of the pancreas induced by gallstones [1]. The initial treatment of ABP can be either conservative or interventional. The coexistence of cholangitis is an accepted indication for the performance of endoscopic retrograde cholangiopancreaticography (ERCP). However, whether this procedure is performed for patients with ABP depends on local expertise and guidelines, as is the decision to perform an endoscopic sphincterotomy (ES) [2][3][4][5].After patients have recovered from their first attack of ABP, most guidelines advocate a cholecystectomy to prevent a recurrent attack or other gallstone-related disorders such as symptomatic choledocholithiasis, cholecystitis, gallstone ileus, jaundice, and cholangitis [2][3][4][5]. ''Recurrent'' symptomatic choledocholithiasis after an initial attack of ABP may be preexisting common bile duct (CBD) stones not detected at the time of the primo episode or stones that migrated from the gallbladder into the CBD after initial stone clearance. Choledocholithiasis also may have developed newly within the bile duct after cholecystectomy.

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Section: Endoscopic Sphincterotomy Versus Conservative Managementmentioning

confidence: 99%

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

et al. 2009

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“…4 Many studies agreed that MRCP are the procedure of choice for the diagnosis of hepatobiliary and pancreatic disorders. [12][13][14][15] Recently the use of rectal indomethacin or oral antacid to prevent PEP were mentioned in the literature and this is should be considered in our future procedures. 1,61,6,17 Upper gastrointestinal bleeding were the second most common complication 3.6% (16 cases), however hemorrhage is basically a complication related to sphincterotomy rather than diagnostic ERCP.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography in Benghazi our experience with 443 cases

et al. 2016

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“…Despite the accuracy of sonography and computed tomography scan, these imaging modalities are inferior to MRCP in diagnosis of choledocholithiasis [12][13][14]. Moon et al in their study on bile duct stones in suspected biliary pancreatitis revealed that overall agreement between MRCP and ERCP was 90.6% for detection of bile duct stones and concluded that MRCP can be used to select patients with biliary pancreatitis who require ERCP for intervention [18]. Mohan et al while evaluating the relative roles of MRCP and EUS in investigating CBD calculi "evidence based practice" methods concluded MRCP should be the first line of investigation of CBD calculi [19].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of magnetic resonance cholangiopancreatography in assessing the etiology of acute idiopathic pancreatitis

Gn¹,

Amin²,

Shaheen³

et al. 2014

Int J Hepatobiliary Pancreat Dis

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Aims: Idiopathic pancreatitis may be diagnosed once all causes of pancreatitis are excluded by thorough history, metabolic profile and conventional imaging modality, i.e., abdominal ultrasonography. In this study, we have attempted to evaluate the cause of idiopathic pancreatitis with the help of magnetic resonance cholangiopancreatography (MrcP). Methods: Fifty patients presenting with idiopathic pancreatitis were assessed prospectively using MrcP with strength 1.5 tesla for potential cause of the attack of pancreatitis. results: Magnetic resonance cholangiopancreatography was able to establish the cause of pancreatitis in eleven (22%) patients, as follows. common bile duct stone in one (2%), pancreatic divisum in one (2%), gallbladder stone in one (2%), pancreatic duct stone in one (2%), chronic pancreatitis in two (4%), gallbladder sludge in two (4%) and anomalous pancreaticobiliary union in three

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The Detection of Bile Duct Stones in Suspected Biliary Pancreatitis: Comparison of MRCP, ERCP, and Intraductal US

Abstract: MRCP can be used to select patients with biliary pancreatitis who require ERCP. IDUS may be applied in the management of biliary pancreatitis if ERCP is performed.

Cited by 189 publications

References 30 publications

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

Endoscopic retrograde cholangiopancreatography in Benghazi our experience with 443 cases

The efficacy of magnetic resonance cholangiopancreatography in assessing the etiology of acute idiopathic pancreatitis

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