BMC Gastroenterology (Jan 2024)

Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC

  • Xu Guo,
  • Qing Fan,
  • Yiman Guo,
  • Xinming Li,
  • Jili Hu,
  • Zhuoyin Wang,
  • Jing Wang,
  • Kai Li,
  • Nengwei Zhang,
  • Buhe Amin,
  • Bin Zhu

DOI
https://doi.org/10.1186/s12876-023-03117-3
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 8

Abstract

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Abstract Background In the past quite a long time, intraoperative cholangiography(IOC)was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patients undergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. Methods According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. Results Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCP were higher than those by abdominal ultrasound (P 0.05), but there was significant difference in hospitalization expenses (P 0.05). Conclusions The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.

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