Imaging patients with 'post-cholecystectomy syndrome': an algorithmic approach
| Autor: | O.A. Terhaar, J.C. Varghese, S. Abbas, P. O'Kelly, M.J. Lee, D. Duke, K. Abdullah, Frank J. Thornton |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Cholangiopancreatography Magnetic Resonance medicine.medical_treatment digestive system Sensitivity and Specificity Liver Function Tests Medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Ultrasonography Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography Cholestasis medicine.diagnostic_test Common bile duct business.industry Bile duct Gallbladder General Medicine Middle Aged medicine.anatomical_structure Choledocholithiasis Biliary tract Cholecystectomy Female Radiology Liver function business Postcholecystectomy Syndrome |
| Zdroj: | Clinical radiology. 60(1) |
| ISSN: | 0009-9260 |
| Popis: | To assess the role of ultrasound (US), magnetic resonance cholangiopancreatography (MRCP) and liver function tests (LFTs) in the evaluation of selected patients presenting with late post-cholecystectomy syndrome (PCS) who were referred for endoscopic retrograde cholangiopancreatography (ERCP).In a retrospective study a final group of 42 patients with PCS referred for diagnostic ERCP underwent MRCP and abdominal US. ERCP and MRCP images were assessed for bile duct diameters and the presence of strictures and stones. A common bile duct (CBD) diameter of10mm was considered normal, whereasor = 10mm was considered abnormal on US. Findings were correlated to LFTs with contingency table results performed for single techniques and combination of methods.In total 14 stones and one stricture were seen. US had a high negative predictive value (86.4%). MRCP had a sensitivity of 100% and specificity of 88.0%. ERCP is the most accurate test but failed in 11 patients, five of whom had a stone. The accuracy of US and LFTs increases to 93.8% if test results agree in either negative or positive outcome.US and LFTs are first-line tests in PCS. If the CBD on US isor = 10mm, but no cause is identified, MRCP should be performed. If US and LFTs are normal then MRCP is not necessary. The availability of LFTs raises the diagnostic value of imaging. |
| Databáze: | OpenAIRE |
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