Preoperative routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy: A prospective study
To assess the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in detecting common bile duct stones in the preoperative investigation of patients electively referred for gallstone disease, to find out the incidence of asymptomatic common duct stones, and to correlate clinical s...
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| Veröffentlicht in: | The European journal of surgery 2002, Vol.168 (12), p.690-694 |
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| container_title | The European journal of surgery |
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| creator | JENDRESEN, M. B THORBØLL, J. E ADAMSEN, S NIELSEN, H GRØNVALL, S HART-HANSEN, O |
| description | To assess the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in detecting common bile duct stones in the preoperative investigation of patients electively referred for gallstone disease, to find out the incidence of asymptomatic common duct stones, and to correlate clinical symptoms and history and liver function tests (LFT) with the actual occurrence of common duct stones.
Prospective study.
General hospital, Denmark.
180 consecutive non-jaundiced patients referred with symptomatic gallstones for elective cholecystectomy.
LFT, abdominal ultrasonography, MRCP, endoscopic retrograde cholangiopancreatography (ERCP), questionnaire.
Positive and negative predictive values and accuracy of MRCP, number of patients with asymptomatic stones, and correlation of symptoms with the presence of stones.
26/180 patients had common duct stones (14%). Only one ( |
| doi_str_mv | 10.1080/11024150201680024 |
| format | Article |
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Prospective study.
General hospital, Denmark.
180 consecutive non-jaundiced patients referred with symptomatic gallstones for elective cholecystectomy.
LFT, abdominal ultrasonography, MRCP, endoscopic retrograde cholangiopancreatography (ERCP), questionnaire.
Positive and negative predictive values and accuracy of MRCP, number of patients with asymptomatic stones, and correlation of symptoms with the presence of stones.
26/180 patients had common duct stones (14%). Only one (<1%) had an asymptomatic stone. For detection of such stones, MRCP's positive predictive value was 0.95 (95% confidence interval (CI): 0.86 to 1.00), negative predictive value 0.96 (0.93 to 0.99), and accuracy 0.85 (0.93 to 0.99). MRCP missed 5 stones 1-4 mm in size in 5 patients; 17/64 patients with raised LFTs had stones (27%). The probability of stones was highest when the patients had both raised LFTs and a dilated common (>7 mm) bile duct (82%). There were no readmissions with ductal stones in the 6-month postoperative period.
The predicive values of MRCP were fairly good, but MRCP misses some small stones <5 mm in size. Asymptomatic stones in the common duct are not common in this population and should not be screened for. The probability of stones increases with the number of predictive factors. Patients should be questioned carefully about signs of biliary obstruction, and only be offered preoperative MRCP should they have a suspicious history, raised LFTs, or a dilated common duct.</description><identifier>ISSN: 1102-4151</identifier><identifier>EISSN: 1741-9271</identifier><identifier>DOI: 10.1080/11024150201680024</identifier><identifier>PMID: 15362577</identifier><language>eng</language><publisher>Basingstoke: Taylor & Francis</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Chi-Square Distribution ; Cholangiopancreatography, Endoscopic Retrograde - methods ; Cholecystectomy, Laparoscopic ; Confidence Intervals ; Denmark ; Digestive system ; Female ; Follow-Up Studies ; Gallstones - diagnosis ; Gallstones - surgery ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Predictive Value of Tests ; Preoperative Care - methods ; Prospective Studies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Risk Assessment ; Sensitivity and Specificity ; Severity of Illness Index ; Treatment Outcome ; Ultrasonography, Doppler</subject><ispartof>The European journal of surgery, 2002, Vol.168 (12), p.690-694</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-27b10bca1b114669eb8433a16fdbc3351c2a5918c9f4570660e11bacb25e64983</citedby><cites>FETCH-LOGICAL-c393t-27b10bca1b114669eb8433a16fdbc3351c2a5918c9f4570660e11bacb25e64983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14793006$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15362577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>JENDRESEN, M. B</creatorcontrib><creatorcontrib>THORBØLL, J. E</creatorcontrib><creatorcontrib>ADAMSEN, S</creatorcontrib><creatorcontrib>NIELSEN, H</creatorcontrib><creatorcontrib>GRØNVALL, S</creatorcontrib><creatorcontrib>HART-HANSEN, O</creatorcontrib><title>Preoperative routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy: A prospective study</title><title>The European journal of surgery</title><addtitle>Eur J Surg</addtitle><description>To assess the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in detecting common bile duct stones in the preoperative investigation of patients electively referred for gallstone disease, to find out the incidence of asymptomatic common duct stones, and to correlate clinical symptoms and history and liver function tests (LFT) with the actual occurrence of common duct stones.
Prospective study.
General hospital, Denmark.
180 consecutive non-jaundiced patients referred with symptomatic gallstones for elective cholecystectomy.
LFT, abdominal ultrasonography, MRCP, endoscopic retrograde cholangiopancreatography (ERCP), questionnaire.
Positive and negative predictive values and accuracy of MRCP, number of patients with asymptomatic stones, and correlation of symptoms with the presence of stones.
26/180 patients had common duct stones (14%). Only one (<1%) had an asymptomatic stone. For detection of such stones, MRCP's positive predictive value was 0.95 (95% confidence interval (CI): 0.86 to 1.00), negative predictive value 0.96 (0.93 to 0.99), and accuracy 0.85 (0.93 to 0.99). MRCP missed 5 stones 1-4 mm in size in 5 patients; 17/64 patients with raised LFTs had stones (27%). The probability of stones was highest when the patients had both raised LFTs and a dilated common (>7 mm) bile duct (82%). There were no readmissions with ductal stones in the 6-month postoperative period.
The predicive values of MRCP were fairly good, but MRCP misses some small stones <5 mm in size. Asymptomatic stones in the common duct are not common in this population and should not be screened for. The probability of stones increases with the number of predictive factors. Patients should be questioned carefully about signs of biliary obstruction, and only be offered preoperative MRCP should they have a suspicious history, raised LFTs, or a dilated common duct.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - methods</subject><subject>Cholecystectomy, Laparoscopic</subject><subject>Confidence Intervals</subject><subject>Denmark</subject><subject>Digestive system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gallstones - diagnosis</subject><subject>Gallstones - surgery</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care - methods</subject><subject>Prospective Studies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Risk Assessment</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler</subject><issn>1102-4151</issn><issn>1741-9271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkE1LxDAQhoMofqz-AC_Si96qmaRNGm8ifoGgBz2XJDvdrbRNTVKh_94sLuzB08wwzzsfLyHnQK-BVvQGgLICSsooiIqmfI8cgywgV0zCfspTP08AHJGTEL4opcAlOyRHUHLBSimPyfzu0Y3odWx_MPNuiu2AWa9XA8bWZh6DG_RgMbNr1-lh1boxlR51dCuvx_WcGWycx6zTo_YuWDcm2QZGO4eINrp-vs3usjE1x1Ru1oQ4LedTctDoLuDZNi7I5-PDx_1z_vr29HJ_95pbrnjMmTRAjdVgAAohFJqq4FyDaJbGcl6CZbpUUFnVFKWkQlAEMNoaVqIoVMUX5Opvbrrge8IQ674NFrv0Dbop1JIpBmWhEgh_oE2nBo9NPfq2136ugdYbv-t_fifNxXb4ZHpc7hRbgxNwuQV0sLprfHKvDTuukIpTKvgv3lmKiw</recordid><startdate>2002</startdate><enddate>2002</enddate><creator>JENDRESEN, M. B</creator><creator>THORBØLL, J. E</creator><creator>ADAMSEN, S</creator><creator>NIELSEN, H</creator><creator>GRØNVALL, S</creator><creator>HART-HANSEN, O</creator><general>Taylor & Francis</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2002</creationdate><title>Preoperative routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy: A prospective study</title><author>JENDRESEN, M. B ; THORBØLL, J. E ; ADAMSEN, S ; NIELSEN, H ; GRØNVALL, S ; HART-HANSEN, O</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-27b10bca1b114669eb8433a16fdbc3351c2a5918c9f4570660e11bacb25e64983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - methods</topic><topic>Cholecystectomy, Laparoscopic</topic><topic>Confidence Intervals</topic><topic>Denmark</topic><topic>Digestive system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gallstones - diagnosis</topic><topic>Gallstones - surgery</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care - methods</topic><topic>Prospective Studies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Risk Assessment</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>JENDRESEN, M. B</creatorcontrib><creatorcontrib>THORBØLL, J. E</creatorcontrib><creatorcontrib>ADAMSEN, S</creatorcontrib><creatorcontrib>NIELSEN, H</creatorcontrib><creatorcontrib>GRØNVALL, S</creatorcontrib><creatorcontrib>HART-HANSEN, O</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>JENDRESEN, M. B</au><au>THORBØLL, J. E</au><au>ADAMSEN, S</au><au>NIELSEN, H</au><au>GRØNVALL, S</au><au>HART-HANSEN, O</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy: A prospective study</atitle><jtitle>The European journal of surgery</jtitle><addtitle>Eur J Surg</addtitle><date>2002</date><risdate>2002</risdate><volume>168</volume><issue>12</issue><spage>690</spage><epage>694</epage><pages>690-694</pages><issn>1102-4151</issn><eissn>1741-9271</eissn><abstract>To assess the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in detecting common bile duct stones in the preoperative investigation of patients electively referred for gallstone disease, to find out the incidence of asymptomatic common duct stones, and to correlate clinical symptoms and history and liver function tests (LFT) with the actual occurrence of common duct stones.
Prospective study.
General hospital, Denmark.
180 consecutive non-jaundiced patients referred with symptomatic gallstones for elective cholecystectomy.
LFT, abdominal ultrasonography, MRCP, endoscopic retrograde cholangiopancreatography (ERCP), questionnaire.
Positive and negative predictive values and accuracy of MRCP, number of patients with asymptomatic stones, and correlation of symptoms with the presence of stones.
26/180 patients had common duct stones (14%). Only one (<1%) had an asymptomatic stone. For detection of such stones, MRCP's positive predictive value was 0.95 (95% confidence interval (CI): 0.86 to 1.00), negative predictive value 0.96 (0.93 to 0.99), and accuracy 0.85 (0.93 to 0.99). MRCP missed 5 stones 1-4 mm in size in 5 patients; 17/64 patients with raised LFTs had stones (27%). The probability of stones was highest when the patients had both raised LFTs and a dilated common (>7 mm) bile duct (82%). There were no readmissions with ductal stones in the 6-month postoperative period.
The predicive values of MRCP were fairly good, but MRCP misses some small stones <5 mm in size. Asymptomatic stones in the common duct are not common in this population and should not be screened for. The probability of stones increases with the number of predictive factors. Patients should be questioned carefully about signs of biliary obstruction, and only be offered preoperative MRCP should they have a suspicious history, raised LFTs, or a dilated common duct.</abstract><cop>Basingstoke</cop><pub>Taylor & Francis</pub><pmid>15362577</pmid><doi>10.1080/11024150201680024</doi><tpages>5</tpages></addata></record> |
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| ispartof | The European journal of surgery, 2002, Vol.168 (12), p.690-694 |
| issn | 1102-4151 1741-9271 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Biological and medical sciences Chi-Square Distribution Cholangiopancreatography, Endoscopic Retrograde - methods Cholecystectomy, Laparoscopic Confidence Intervals Denmark Digestive system Female Follow-Up Studies Gallstones - diagnosis Gallstones - surgery Gastroenterology. Liver. Pancreas. Abdomen Humans Investigative techniques, diagnostic techniques (general aspects) Liver. Biliary tract. Portal circulation. Exocrine pancreas Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Other diseases. Semiology Predictive Value of Tests Preoperative Care - methods Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk Assessment Sensitivity and Specificity Severity of Illness Index Treatment Outcome Ultrasonography, Doppler |
| title | Preoperative routine magnetic resonance cholangiopancreatography before laparoscopic cholecystectomy: A prospective study |
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