Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?
Cholecystectomy
Laparoscopic
Magnetic resonance cholangiopancreatography
Journal
Annals of surgical treatment and research
ISSN: 2288-6575
Titre abrégé: Ann Surg Treat Res
Pays: Korea (South)
ID NLM: 101622895
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
16
04
2020
revised:
05
06
2020
accepted:
16
07
2020
entrez:
8
10
2020
pubmed:
9
10
2020
medline:
9
10
2020
Statut:
ppublish
Résumé
We evaluated the impact of preoperative magnetic resonance cholangiopancreatography (MRCP) on patient outcomes, and found which patients should be considered for MRCP before cholecystectomy. We performed retrospective analysis of 2,072 patients that underwent cholecystectomy for benign gallbladder disease from January 2014 to June 2017. Patients were grouped as CT only group (n = 737) and MRCP group (n = 1,335), including both CT and MRCP (n = 1,292) or MRCP only (n = 43). The main outcome measure was associated with complications after cholecystectomy, and the secondary outcomes were hospital stay, readmission, and events that could impact patient management due to addition of MRCP. There were no statistical differences in occurrence of intraoperative or postoperative complications or readmission rate between the 2 groups. Hospital stay was about 0.6 days longer in the MRCP group. However, MRCP group was more susceptible to complications due to underlying patient demographics (older age, higher frequency of diabetes, and higher level of the inflammatory markers). MRCP diagnosed common bile duct (CBD) stones in 6.5% of patients (84/1,292) without CBD stones in CT, and bile duct anomalies were identified in 41 patients (3.2%). Elevated γ-GT was the only independent factor for additional detection of CBD stones (adjusted odds ratio [OR], 2.89; P = 0.029) and subsequent biliary procedures (adjusted OR, 3.34; P = 0.018) when additional MRCP was performed. MRCP is valuable for identification of bile duct variation and CBD stones. Preoperative MRCP can be considered, particularly in patients with elevated γ-GT, for proper preoperative management and avoidance of complications.
Identifiants
pubmed: 33029481
doi: 10.4174/astr.2020.99.4.221
pmc: PMC7520229
doi:
Types de publication
Journal Article
Langues
eng
Pagination
221-229Informations de copyright
Copyright © 2020, the Korean Surgical Society.
Déclaration de conflit d'intérêts
Conflict of Interest: No potential conflict of interest relevant to this article was reported.
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