The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy

Terrence H. Liu, Eileen T. Consorti, Akira Kawashima, Randy D. Ernst, C. Thomas Black, Philip H. Greger, Ronald P. Fischer, David W. Mercer

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

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. Copyright (C) 1999 Excerpta Medica Inc.

Original languageEnglish (US)
Pages (from-to)480-484
Number of pages5
JournalAmerican Journal of Surgery
Volume178
Issue number6
DOIs
StatePublished - Dec 1 1999
Externally publishedYes

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Choledocholithiasis
Cholangiography
Laparoscopic Cholecystectomy
Magnetic Resonance Spectroscopy
Common Bile Duct
Patient Selection

ASJC Scopus subject areas

  • Surgery

Cite this

The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy. / Liu, Terrence H.; Consorti, Eileen T.; Kawashima, Akira; Ernst, Randy D.; Black, C. Thomas; Greger, Philip H.; Fischer, Ronald P.; Mercer, David W.

In: American Journal of Surgery, Vol. 178, No. 6, 01.12.1999, p. 480-484.

Research output: Contribution to journalArticle

Liu, Terrence H. ; Consorti, Eileen T. ; Kawashima, Akira ; Ernst, Randy D. ; Black, C. Thomas ; Greger, Philip H. ; Fischer, Ronald P. ; Mercer, David W. / The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy. In: American Journal of Surgery. 1999 ; Vol. 178, No. 6. pp. 480-484.
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abstract = "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. Copyright (C) 1999 Excerpta Medica Inc.",
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AU - Ernst, Randy D.

AU - Black, C. Thomas

AU - Greger, Philip H.

AU - Fischer, Ronald P.

AU - Mercer, David W.

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