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2014, Number 2

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Rev Latinoam Cir 2014; 4 (2)

Role of magnetic resonance cholangiography in the diagnosis of choledocholithiasis

Cantileno P, Vanerio P, Cossa J, Liford PP, Valiñas R, de la Fuente S

Language: Spanish
References: 34
Page: 65-69
PDF size: 220.40 Kb.


ABSTRACT

Introduction: Miniinvasives approaches of the biliary track arisen great interest in preoperative diagnosis of choledocholithiasis .The method of choice have been the invasive endoscopic retrograde or intra operative colangiography. Magnetic resonance cholangiography (MRC) is not an invasive method, without morbidity and mortality. With a high sensitivity, specificity and predictive values​​. The aim of this study it’s to evaluate the magnetic resonance cholangiopancreatography in the diagnosis of choledocholithiasis in the University Hospital of Montevideo, Uruguay.
Material and methods: Prospective observational study. Data collected over a period of almost 2 years. The MRC was compared with direct cholangiography either endoscopic or intraoperative. According to the findings of the MRCP. If it´s positive for choledocolithiasis proceeded to perform cholangiography with endoscopic papilotomy, in negative cases, we proceeded laparoscopic cholecystectomy with intraoperative cholangiography.
Results: We compared MRC with direct cholangiography in 32 patients. A sensitivity of 84.6% and a specificity of 89.5% was obtained. The positive predictive value was 84.6% and the negative predictive value of 89.5%. With a Kappa coefficient of 0.74 with a 95% CI and p ‹ 0.05.
Conclusions: Magnetic resonance cholangiography is an effective method. It’s value lies in select patients to perform endoscopic cholangiography with papilotomy performed avoiding unnecessary endoscopy retrograde colangiopancreatography and the mapping of the biliar track. The sensitivity, specificity and predictive values ​​are similar to the International publications.


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