A szekretinnel érzékenyített mágneses rezonanciás cholangiopancreatographia (S-MRCP) diagnosztikus értéke sikertelen endoszkópos retrográd cholangiopancreatographia (ERCP) esetén

Translated title of the contribution: Diagnostic value of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP)

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Abstract

Background and aims: To evaluate the value of S-MRCP in patients in whom ERCP performed by experts in a tertiary center were unsuccessful. Patients and methods: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n = 8), suspected chronic pancreatitis (n = 2), recurrent pancreatitis (n = 2) or suspected pancreatic cancer (n = 1). The reasons for the ERCP failure were postsurgical anatomy (n = 7), duodenum stenosis (n = 3), duodenal diverticulum (n = 2), or technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after the i.v. administration of 0.5 IU/kg secretin. Results: The MRCP images were diagnostic in all but 1 patient. Five patients gave normal MR fadings and required no further intervention. S-MRCP detected abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilatation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepatico-jejunostomy owing to common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy + Kehr drainage because of narrow biliary-enteric anastomosis; choledocho-jejunostomy, gastro-jejunostomy and Wirsungo-gastrostomy in consequence of chronic pancreatitis or choledocho-jejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage; the indications were choledocholithiasis in one patient choledocho-jejunostomy anastomosis, narrow biliary-enteric anastomosis, or cholangiocarcinoma. Conclusion: S-MRCP is the method of choice in cases where ERCP is not possible.

Original languageHungarian
Pages (from-to)529-534
Number of pages6
JournalOrvosi hetilap
Volume145
Issue number10
Publication statusPublished - Mar 1 2004

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ASJC Scopus subject areas

  • Medicine(all)

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