Abstract

Background
Cholecystectomy can be performed as an open procedure via laparotomy, using a conventional (open)
incision (OC) or a mini-incision (MC) or using a laparoscopic procedure (LC). MR is excellent for
visualisation of the biliary tract including abnormalities as common bile duct stones, postoperative
fluid collections and bilomas, but also other pathological conditions in the abdomen such as
abscesses. The aim of this study was to use magnetic resonance cholangiopancreatography (MRCP)
as a non-invasive alternative to identify Post Laparoscopic Cholecystectomy Biliary Duct Injuries and
compare it with ERCP and post operative findings.
Methods
After receiving ethical approval, the current prospective study was conducted for two years in the
Department of Internal Medicine among patients with clinical findings suggestive of postoperative
bile duct injury who visited the OPD or were admitted to the wards and underwent MRCP followed
by ERCP. Clinical history was gathered during OPD hours or after admission, and patient-specific
and pertinent information was acquired through interviews in a structured data collection schedule.
All tests were done at a 5% level of significance; an association was considered significant if the p
value was < 0.05.
Results
In present study, the mean age of patients was 42.3 22.7 years. 82% of patients were females. Among
70% of patients’ persistent right upper quadrant pain was the clinical symptom followed by jaundice
(48%). Type II (36%) and Type III (38%) were the common observed Bismuth Injury on MRCP.
While comparing the bismuth injury on MRCP findings with intraoperative findings, it was observed
that Type II and Type II injuries were accurately diagnosed by MRCP and matches with the
intraoperative findings. Strictures with associated dilated IHBR were more accurately diagnosed by
MRCP (50% of patients) when compared with ERCP (36% of patients).
Conclusion
Our preliminary results support that MRCP is a useful diagnostic test in patients suspected to have
bile duct injury after surgery. MRCP depicts the signs of stricture and excision injury accurately and
displays the anatomy completely and accurately.