OBJECTIVES The importance of papillary obstruction in the pathogenesis of acute biliary pancreatitis is widely recognized. The aim of this study was to evaluate the usefulness of the MRCP before the VLC in the patients with mild acute biliary pancreatitis. METHODS In the period 2003-2007, 35 patients were submitted to a MRCP (F/M:20/15) with mild ABP without increase of the cholestasis tests and absence of choledocholithiasis at the abdominal USG. During a followup from 15 to 60 days after the VLC, the presence of jaundice or relapse of ABP were evaluated in all patients. RESULTS Ten patients had diagnosis of choledocholithiasis at the MRCP and they were submitted to an ERCP, endoscopic sphincterotomy and stones removal; 25 patients with a negative MRCP were submitted to the VLC. All the 35 patients submitted to the MRCP before the VLC did not have jaundice or relapse of the ABP during the follow-up period. CONCLUSIONS The MRCP was an accurate investigation for the preoperatory diagnosis of choledocholithiasis; even if it is not possible to recommend its utilization extensively, it is an important procedure for the patients with diagnosis of mild ABP to select all those to submit to the ERCP.
Mild-moderate acute biliary pancreatitis: role of magnetic resonance cholangiopancreatography in preparation of cholecystectomy.
NERI, VINCENZO;FERSINI, ALBERTO;AMBROSI, ANTONIO;TARTAGLIA, NICOLA;
2009-01-01
Abstract
OBJECTIVES The importance of papillary obstruction in the pathogenesis of acute biliary pancreatitis is widely recognized. The aim of this study was to evaluate the usefulness of the MRCP before the VLC in the patients with mild acute biliary pancreatitis. METHODS In the period 2003-2007, 35 patients were submitted to a MRCP (F/M:20/15) with mild ABP without increase of the cholestasis tests and absence of choledocholithiasis at the abdominal USG. During a followup from 15 to 60 days after the VLC, the presence of jaundice or relapse of ABP were evaluated in all patients. RESULTS Ten patients had diagnosis of choledocholithiasis at the MRCP and they were submitted to an ERCP, endoscopic sphincterotomy and stones removal; 25 patients with a negative MRCP were submitted to the VLC. All the 35 patients submitted to the MRCP before the VLC did not have jaundice or relapse of the ABP during the follow-up period. CONCLUSIONS The MRCP was an accurate investigation for the preoperatory diagnosis of choledocholithiasis; even if it is not possible to recommend its utilization extensively, it is an important procedure for the patients with diagnosis of mild ABP to select all those to submit to the ERCP.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
