Magnetic Resonance Cholangiopancreatography in Post Laparoscopic Cholecystectomy Patients

Waleed S. Mahafza, Azmi M. AI-Hadidy, Azmi A. Haroun, Emad S. Tarawneh, Salam S. Daradkeh, Mustafa M. Shennak

Abstract


Objectives: To determine the usefulness and diagnostic performance of Magnetic Resonance Cholangiopancreatography (MRCP) combined with Conventional Abdominal Magnetic Resonance Examination (CAMRE) in post laparoscopic cholecystectomy patients, and to compare the results with Endoscopic Retrograde Cholangiopancreatography (ERCP).
Methods: The study group consisted of 113 patients (30 men and 83 women) who had undergone laparoscopic cholecystectomy. Magnetic Resonance Imaging (MRI) examinations were performed with 1.5 T super conducting unit (magnetom vision plus, siemens). Conventional magnetic resonance imaging of the upper abdomen followed by magnetic resonance cholangiopancreatography using a half fourrier single shot turbo spin-echo sequences were done for all patients. Findings were correlated with endoscopic retrograde cholangiopancreatography, ultrasound and clinical follow up.
Results:
Magnetic resonance cholangiopancreatography was adequate in all patients. Fifty three (47%) patients had normal MRCP findings. In 60 (53%) patients, MRCP showed biliary dilatation. Bile duct stones were diagnosed in 19 (17%) of them and strictures of the bile ducts and papilla in 26 (23%) of the patients. The nature of the strictures was: benign in 16 patients and malignant in 10 patients. In 15 (13%) patients no evidence of obstructive bile duct disease was demonstrated. The overall sensitivity, specificity and accuracy of MRCP in the detection of bile duct lesions in post laparoscopic cholecystectomized patients were: 93%, 99% and 97%, respectively.
Conclusions: We conclude that MRCP can offer a non-invasive highly effective diagnostic modality for the evaluation of patients with post cholecystectomy biliary disorders.

Keywords


Magnetic Resonance Cholangiopancreatography, Laparoscopic Cholecystectomy, bile ducts.

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