Improving the Safety of Laparoscopic Cholecystectomy: the Routine Use of Preoperative Magnetic Resonance Cholangiography

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2005 Mar 11

PMID 15759179

Citations 21

Authors

C Ausch

G Hochwarter

M Taher

B Holzer

H R Rosen

M Urban

C Sebesta

W Hruby

R Schiessel

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to determine the value of routinely performed preoperative magnetic resonance cholangiography (MRC) in detecting common bile duct (CBD) stones in patients stated to undergo elective laparoscopic cholecystectomy. In addition, we used MRC to investigate possible variants of the cystic duct.

Methods: Magnetic resonance cholangiography was performed preoperatively in 773 patients (311 male and 462 female; median age 55 years, range 16-91) who had no clinical signs of cholestasis prior to undergoing elective laparoscopic cholecystectomy. In cases where the MRC was positive for CBD stones, endoscopic retrograde cholangiopancreatiography (ERCP) was then performed. A total of 532 patients were available for continuous postoperatively follow-up (median 54 months, range 36-85). In 462 patients (247 female, and 215 male), MR images were also reviewed for variants of the cystic duct.

Results: In 705 patients (91%), MRC was negative for CBD stones. In 64 patients (9%) MRC was positive. Of these patients, 47 (6%) had CBD stones on ERCP. In 12 patients (2%), MRC was false positive. In five cases (0.6%), ERCP had an inconclusive result postoperative follow-up (532 patients, or 69%) revealed evidence of CBD stones in three patients (10.4%) despite a preoperative negative MRC result. Anatomical variants in the course of the cystic duct and its confluence with the common bile duct were found in 27 of 462 patients (6%).

Conclusions: Magnetic resonance cholangiography proved to be a reliable screening technique in the preoperative evaluation of patients with silent CBD stones. Imaging of the course of the cystic duct is possible in a high percentage of cases. Therefore, MRC can be recommended as a screening technique before laparoscopic cholecystectomy.

Citing Articles

A Single Centre Experience With Routine Magnetic Resonance Cholangiopancreatography in the Management of Patients With Gall Stone Disease.

Pareek T, R R, R P, Chidambaranathan S, O L N Cureus. 2021; 13(10):e18743.

PMID: 34790490 PMC: 8588194. DOI: 10.7759/cureus.18743.

A New Quantitative Classification of the Extrahepatic Biliary Tract Related to Cystic Duct Implantation.

Renzulli M, Brocchi S, Marasco G, Spinelli D, Balacchi C, Barakat M J Gastrointest Surg. 2020; 25(9):2268-2279.

PMID: 33269458 PMC: 8484130. DOI: 10.1007/s11605-020-04852-8.

Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?.

Kang K, Kwon H, Ham S, Park H, Shin J, Lee S Ann Surg Treat Res. 2020; 99(4):221-229.

PMID: 33029481 PMC: 7520229. DOI: 10.4174/astr.2020.99.4.221.

Successful management of aberrant right hepatic duct during laparoscopic cholecystectomy: a rare case report.

Oyama K, Nakahira S, Ogawa H, Kato K, Hasegawa M, To T Surg Case Rep. 2019; 5(1):74.

PMID: 31073708 PMC: 6509294. DOI: 10.1186/s40792-019-0632-7.

Laparoendoscopic rendezvous may be an effective alternative to a failed preoperative endoscopic retrograde cholangiopancreatography in patients with cholecystocholedocholithiasis.

Tsiopoulos F, Kapsoritakis A, Psychos A, Manolakis A, Oikonomou K, Tzovaras G Ann Gastroenterol. 2018; 31(1):102-108.

PMID: 29333074 PMC: 5759603. DOI: 10.20524/aog.2017.0210.

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