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To assess the frequency of choledocolithiasis and the role of preoperative laboratory findings, ultrasound (US) and magnetic resonance cholangio-pancreatography (MRCP) in the detection of choledocolithiasis in patients with gallbladder stones awaiting cholecystectomy.
A consecutive sample of 104 patients underwent MRCP prior to cholecystectomy. The patients were classified into different groups on the basis of the risk of choledocolithiasis. A specialised doctor with more 10 years of experience performed the US interpretation and a radiologist performed the MRCP interpretation blinded to US or aspartate aminotransferase (AST)/alanine aminotransferase (ALT)/alkaline phosphatase (ALP) results. A chi-square (χ2) test was performed to assess the statistical significance of differences in the frequency of choledocolithiasis based on laboratory findings, choledocal diameter on US and group risk.
MRCP showed calculi in 7 out of 104 patients (6.7%), with no statistically significant differences between the high/moderate risk and low/no risk groups and between the patients with normal and altered laboratory findings or choledocal diameter on preoperative US. The sensitivity and specificity of AST/ALT [positive predictive value (PPV): 12%; negative predictive value (NPV): 94%], ALP (PPV: 7%; NPV: 94%), total serum bilirubin (PPV: 6%; NPV: 93%) and choledocal diameter (PPV: 20%; NPV: 94%) were, respectively, 28.6 and 94.8%, 85.7 and 17.5%, 14.3 and 93.8%, and 14.3 and 95.9%.
MRCP is a reliable evaluation for the detection of common bile duct (CBD) stones, reducing the misdiagnosis of retained choledocholithiasis with normal biochemical predictors and US examination.
• MRCP is a non-invasive method for the detection of CBD stones.
• Preoperative MRCP reduces the misdiagnosis of retained choledocholithiasis.
• Detection of choledocholithiasis is mandatory prior to cholecystectomy to avoid surgical morbidity
Mercer S, Singh S, Paterson I (2007) Selective MRCP in the management of suspected common bile duct stones. HPB (Oxford) 9(2):125–130 CrossRef
Ke ZW, Zheng CZ, Li JH, Yin K, Hua JD (2003) Prospective evaluation of magnetic resonance cholangiography in patients with suspected common bile duct stones before laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int 2:576–580 PubMed
Videhult P, Sandblom G, Rudberg C, Rasmussen IC (2011) Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones? Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy. HPB (Oxford) 13(8):519–527 CrossRef
Onken JE, Brazer SR, Eisen GM et al (1996) Predicting the presence of choledocholithiasis in patients with symptomatic cholelithiasis. Am J Gastroenterol 91(4):762–767 PubMed
Paolo P, Nicoletta P, Carla M, Andrea M (1990) Ultrasonographic diagnosis of choledocholithiasis. Acta Biomed Ateneo Parmense 61(5–6):213–218 PubMed
Giljaca V, Gurusamy KS, Takwoingi Y et al (2015) Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Data Syst Rev (2):CD011549. https://doi.org/10.1002/14651858.CD011549
- Routine MRCP in the management of patients with gallbladder stones awaiting cholecystectomy: a single-centre experience
Noemi Maria Giovanna Ognibene
Antonio Salvatore Sciortino
- Springer Berlin Heidelberg
- Insights into Imaging
Elektronische ISSN: 1869-4101
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