Online ISSN: 2515-8260

Keywords : Magnetic Resonance Cholangiopancreatography (MRCP)


“A CASE REPORT OF PRIMARY BILE DUCT STONES POST-CHOLECYSTECTOMY.”

Dr. (Col). Sunil. Panchabhai Dr. Vivekananth Subramaniam, Dr. Sudhir Jayakar Dr. Bhavesh Mahajan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2854-2861

Gallstone disease is extremely common in Western societies, with cholecystectomy being the standard treatment for patients with symptomatic gallstones. The incidence of common bile duct stones (CBD) with concomitant gallstones increases with age from 8 to 15% in patients younger than 60 years and up to 60% in the elderly. There are only a few reports of gallstones after cholecystectomy in the literature. Most of these reports describe the presence of stones in the gallbladder/cystic duct remnant or secondary to migration of the surgical clips. We report a single unique case of primary bile duct stones 7 years after open cholecystectomy.

Diagnostic efficacy of ultrasonography against magnetic resonance cholangiopancreatography in obstructive biliopathy

Dr. Biplab Debbarma, Dr. Chandini Reang, Dr. Kaushik Tripura

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1232-1243

Introduction: Obstructive jaundice is one of the most frequent symptoms of hepatobiliary disease and caused by various diseases. So, it is mandatory to determine pre-operatively the existence, the nature and level of obstruction because an ill chosen therapeutic approach can be dangerous. MRCP demonstrates details anatomy and pathology of the biliary and pancreatic ducts. Ultrasonography still remains the first imaging modality for obstructive jaundice. Hence, aim of the present study was to evaluate the diagnostic efficacy of ultrasonography (USG) against magnetic resonance cholangiopancreatography (MRCP) in obstructive biliopathy in detection and characterization in patients suspected with pancreatic and biliary system pathologies.
Material and methods: This study was conducted among sixty patients suffering from obstructive jaundice of all age groups. All the patients in the study underwent ultrasonography and MRCP. The result so obtained was expressed as percentages and variables as required.
Results: In our study, the most common cause of obstructive jaundice was common bile duct stones (55%) followed by tumors (22%) then benign strictures (7%), choledochal cyst (7%), chronic pancreatitis with pseudocysts (7%) and Mirizzi syndrome (3.33%). Diagnostic accuracy of ultrasound in obstructive jaundice taking MRCP findings as gold standard revealed sensitivity, specificity and diagnostic accuracy in benign cases as 97%, 67% and 97.4% and in malignant cases as 86%, 100% and 87.5% respectively.
Conclusion: USG has a high potential efficacy in diagnosing causes of obstructive jaundice. So, it is considered as an initial screening modality to confirm or exclude biliary dilatation & to choose patients for MRCP examination

Assessment of the efficacy of Magnetic Resonance Cholangiopancreatography (MRCP) and Ultrasonography (USG) in detection and characterization in patients suspected with pancreatic and biliary disorder: A comparative study

Dr. Sneha Choudhary; Dr. Gurshaan Singh Makkar; Dr.Deepanshu Suhag; Dr. Shagun Sain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1836-1841

Aim: To compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) with Ultrasound and Computed Tomography (CT) in evaluation of patients with obstructive jaundice.

Comparative assessment to establish the accuracy of MRCP over USG & CT in diagnosing the case of obstructive jaundice

Dr. Sahil Chawla, Dr. Monika Sharma, Dr. Aastha Makkar,Dr. Naresh Tripathi, Dr. Pratibha Gupta, Dr. Naveen Pahal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1113-1118

Aim: To compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography
(MRCP) with Ultrasound and Computed Tomography (CT) in evaluation of patients with
obstructive jaundice.
Methodology: This study was conducted in the Department of Radio Diagnosis, Maharishi
Markandeshwar Medical College and Hospital, Kumarhatti, Solan for the period of 6 months.
60 patients clinically diagnosed as suffering from obstructive jaundice and having total
Bilirubin greater than 5mg/dl were included in this study. Patients who were pregnant and
claustrophobic were not included in this study. All the patients were instructed to fast
overnight prior to examination. Renal functional status, clinical history of all the patients was
noted before undergoing contrast CT. All the patients in the study underwent USG
examination first followed by MRCP and finally CT. Both curvilinear and linear probes were
used in the study. Images of the biliary tree were recorded for later review. Helical CT was
performed on a Philips Healthcare 128 slice CT scanner. MRCP was performed on Philips
Healthcare 1.5 Tesla MRI Scanner. All images were obtained with breath holding and
parameters were individualized.
Results: Of 60 patients, 16 (26.7%) patients were ≤45 years and 44 (73.3%) were >45 years.
32 (53.3%) cases were males and 28 (46.7%) were females. There were 37 (61.7%) patients
with ≤40 days of duration of symptoms and 23 (38.3%) patients with >40 days of duration of
symptoms. In causes of obstruction, choledocholothiasis was responsible
for19(31.7%),stricture16(26.7%),carcinoma ofheadofpancreas11(18.3%),
gallbladdercarcinoma6 (10%), periampullary carcinoma5(8.3%) and cholangiocarcinoma in 3
(5%) of the cases. Taking MRCP as gold standard, 100% (60 cases) had obstructive jaundice.
Whereas 56.7% (34 cases) were diagnosed correctly using USG and 86.7% (52 cases) were
diagnosed correctly using CT. The sensitivity of MRCP is 94% and CT is 92%, while it is
100% for USG. Inspite of the high sensitivity for USG, the specificity for the same is very
low at 70% when compared to that of CT’s 72% and MRCP’s 100%.
Conclusion: The only drawback of MRCP is the cost involved and the availability. From this
study, It is recommended that helical CT can be used as a screening imaging technique to
identify the presence or absence of intrahepatic biliary duct dilatation; thereby shortlisting the
patients for MRCP examination.