Magnetic resonance cholangiopancreatography (MRCP) evaluation of post-laparoscopic cholecystectomy biliary complications using breath-held 3D steady state free precession (SSFP) sequence

To assess the role of breath-held 3D-SSFP MRCP in evaluation of post-laparoscopic cholecystectomy biliary complications. This study included 29 patients with post-laparoscopic cholecystectomy symptoms like abdominal pain, vomiting or jaundice during period from March 2013 to March 2015. The ages of patients ranged from 28 to 70years (mean 49±16year). MRCP was performed for all patients on 1.5 tesla MRI machine with breath-held multi-slice acquisition. Both 2D and 3D MRCP were done. The encountered post laparoscopic biliary complications were either major injuries like complete bile duct transection in 8 cases and bile duct ligation in 4 cases or minor injuries like partial thermal tear in 4 cases, slipped clips in 2 cases and benign strictures in 5 cases. The retained biliary stones were another complication and located either intrahepatic in 2 cases or extra-hepatic in 4 cases. 13 cases were managed by ERCP with sphincterotomy, dilatation and/or T-tube insertion. Other 13 patients were managed operatively with removal of ligature or hepaticojujenostomy and the remaining 3 patients were managed conservatively. The use of breath-held 3D-SSFP MRCP is essential in evaluation of post-laparoscopic cholecystectomy biliary complications and in planning for management regimens.