The Value of Pre-Operative Magnetic Resonance Cholangiopancreatography (MRCP) in Assessment of Patients Undergoing Cholecystectomy Aiming to Reduce Post-Operative Complications, MARYSE Y. AWADALLAH, MOHAMMED A. BADR, REDA S. ABD EL-LATIF and MOHAMMED H. FAHMY
Abstract
Background: High incidence of post-operative complica-tions after laparoscopic cholecystectomy, which has become the gold standard surgery for cholelithiasis, raised the need for biliary imaging as preoperative assessment of the anatom-ical variants and the presence of missed pathologies by US. MRCP is a safe non invasive method that provides similar images to ERCP, without radiation, anesthesia, or iodinated contrast material. It allows better visualization of the hepatic and extra hepatic biliary ducts.
The Aim of Work: This study is aiming to clarify the importance of preoperative MRCP in patients who will be subjected to laparoscopic cholecystectomy, to reduce the incidence of post-operative complication by detection of surgically important biliary tract anatomical variants and pathologies that missed to be detected by US and laboratory biochemical screening.
Patients and Method: Fifty five patients (29 males and 26 females) with clinical suspicion of gall bladder stones, underwent ultrasound, laboratory investigations and MRCP, images were evaluated for anatomical variants and associated pathologies. Data were collected and statistically described.
Results: Two silent stones and twenty six anatomical variants were detected by MRCP and missed by ultrasound.
Conclusion: Routine preoperative MRCP is highly rec-ommended after ultrasound examination for detection of anatomical variants, confirmation and detection of reported and missed pathologies, thus helping the surgeon for preplan-ning and determining the surgical approach in order to avoid post-operative complications.