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Erschienen in: Langenbeck's Archives of Surgery 6/2009

01.11.2009 | Original Article

Is routine MR cholangiopancreatography (MRCP) justified prior to cholecystectomy?

verfasst von: C. A. Nebiker, S. A. Baierlein, S. Beck, M. von Flüe, C. Ackermann, R. Peterli

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2009

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Abstract

Purpose

We investigated routinely the bile ducts by magnetic resonance cholangiopancreaticography (MRCP) prior to cholecystectomy. The aim of this study was to analyze the rate of clinically inapparent common bile duct (CBD) stones, the predictive value of elevated liver enzymes for CBD stones, and the influence of the radiological results on the perioperative management.

Methods

In this prospective study, 465 patients were cholecystectomized within 18 months, mainly laparoscopically. Preoperative MRCP was performed in 454 patients.

Results

With MRCP screening, clinically silent CBD stones were found in 4%. Elevated liver enzymes have only a poor predictive value for the presence of CBD stones (positive predictive value, 21%; negative predictive value, 96%). Compared to the recent literature, the postoperative morbidity in this study was low (0 bile duct injury, 0.4% residual gallstones).

Conclusions

Although MRCP is diagnostically useful in the perioperative management in some cases, its routine use in the DRG-era may not be justified due to the costs.
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Metadaten
Titel
Is routine MR cholangiopancreatography (MRCP) justified prior to cholecystectomy?
verfasst von
C. A. Nebiker
S. A. Baierlein
S. Beck
M. von Flüe
C. Ackermann
R. Peterli
Publikationsdatum
01.11.2009
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2009
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-008-0447-7

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