Document Detail


Imaging patients with "post-cholecystectomy syndrome": an algorithmic approach.
MedLine Citation:
PMID:  15642297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess the role of ultrasound (US), magnetic resonance cholangiopancreatography (MRCP) and liver function tests (LFTs) in the evaluation of selected patients presenting with late post-cholecystectomy syndrome (PCS) who were referred for endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS: In a retrospective study a final group of 42 patients with PCS referred for diagnostic ERCP underwent MRCP and abdominal US. ERCP and MRCP images were assessed for bile duct diameters and the presence of strictures and stones. A common bile duct (CBD) diameter of < 10mm was considered normal, whereas > or = 10mm was considered abnormal on US. Findings were correlated to LFTs with contingency table results performed for single techniques and combination of methods. RESULTS: In total 14 stones and one stricture were seen. US had a high negative predictive value (86.4%). MRCP had a sensitivity of 100% and specificity of 88.0%. ERCP is the most accurate test but failed in 11 patients, five of whom had a stone. The accuracy of US and LFTs increases to 93.8% if test results agree in either negative or positive outcome. CONCLUSION: US and LFTs are first-line tests in PCS. If the CBD on US is > or = 10mm, but no cause is identified, MRCP should be performed. If US and LFTs are normal then MRCP is not necessary. The availability of LFTs raises the diagnostic value of imaging.
Authors:
O A Terhaar; S Abbas; F J Thornton; D Duke; P O'Kelly; K Abdullah; J C Varghese; M J Lee
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Clinical radiology     Volume:  60     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-11     Completed Date:  2005-03-08     Revised Date:  2005-09-06    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  78-84     Citation Subset:  IM    
Affiliation:
Department of Academic Radiology, Beaumont Hospital and Royal College of Surgeons Medical School, Beaumont Road, Dublin, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde / methods
Cholangiopancreatography, Magnetic Resonance / methods
Choledocholithiasis / diagnosis,  radiography,  ultrasonography
Cholestasis / diagnosis,  radiography,  ultrasonography
Female
Humans
Liver Function Tests / methods
Male
Middle Aged
Postcholecystectomy Syndrome / diagnosis*,  radiography,  ultrasonography
Retrospective Studies
Sensitivity and Specificity
Comments/Corrections
Comment In:
Clin Radiol. 2005 Jun;60(6):728-9   [PMID:  16038704 ]

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