Document Detail


The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy.
MedLine Citation:
PMID:  10670857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endoscopic retrograde cholangiography is the most commonly utilized tool for the identification of common bile duct stones (CBDS) before laparoscopic cholecystectomy, whereas the role of magnetic resonance cholangiography (MRC) for patient evaluation before laparoscopic cholecystectomy is currently undefined. METHODS: We prospectively evaluated the efficacy of MRC for the identification of CBDS among patients with high risk for choledocholithiasis. Patient selection was based on clinical, sonographic, and laboratory criteria. Standard cholangiograms were obtained when possible for verification of MRC results. RESULTS: Ninety-nine patients underwent evaluation with preoperative MRC. CBDS was visualized in 30% of patients. MRC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 85%, 90%, 77%, 94%, and 89%, respectively. CONCLUSIONS: MRC is useful for the evaluation of patients with suspected choledocholithiasis. Advantages of MRC include its noninvasive nature, ease of application, and accuracy in identifying and estimating the size of CBDS. Application of MRC in this setting reduces the need for diagnostic endoscopic retrograde cholangiography. Future investigations should be directed at the development of cost-effective utilization strategies for MRC application.
Authors:
T H Liu; E T Consorti; A Kawashima; R D Ernst; C T Black; P H Greger; R P Fischer; D W Mercer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  178     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-03-07     Completed Date:  2000-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  480-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, The University of Texas, Houston Health Science Center at Lyndon B. Johnson General Hospital, 77026-1967, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Cholangiopancreatography, Endoscopic Retrograde / utilization
Cholecystectomy, Laparoscopic*
Female
Gallstones / diagnosis*
Humans
Magnetic Resonance Imaging* / utilization
Male
Predictive Value of Tests
Preoperative Care
Prospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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