[Diagnostic value of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP)].

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  • Additional Information
    • Transliterated Title:
      A szekretinnel érzékenyített mágneses rezonanciás cholangiopancreatographia (S-MRCP) diagnosztikus értéke sikertelen endoszkópos retrográd cholangiopancreatographia (ERCP) esetén.
    • Source:
      Publisher: Akademiai Kiado Country of Publication: Hungary NLM ID: 0376412 Publication Model: Print Cited Medium: Print ISSN: 0030-6002 (Print) Linking ISSN: 00306002 NLM ISO Abbreviation: Orv Hetil Subsets: MEDLINE
    • Publication Information:
      Publication: 2007- : Budapest : Akademiai Kiado
      Original Publication: Pest : Markusovszky Lajos
    • Subject Terms:
      Cholangiopancreatography, Endoscopic Retrograde* ; Secretin*; Biliary Tract Diseases/*diagnosis ; Cholangiography/*methods ; Magnetic Resonance Imaging/*methods ; Pancreatic Diseases/*diagnosis; Adult ; Aged ; Biliary Tract Diseases/diagnostic imaging ; Biliary Tract Diseases/surgery ; Diagnosis, Differential ; Female ; Humans ; Jaundice, Obstructive/diagnosis ; Male ; Middle Aged ; Pancreatic Diseases/diagnostic imaging ; Pancreatic Diseases/surgery ; Pancreatic Neoplasms/diagnosis ; Pancreatitis/diagnosis ; Predictive Value of Tests
    • Abstract:
      Background and Aims: To evaluate the value of S-MRCP in patients in whom ERCP performed by experts in a tertiary center were unsuccessful.
      Patients and Methods: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n = 8), suspected chronic pancreatitis (n = 2), recurrent pancreatitis (n = 2) or suspected pancreatic cancer (n = 1). The reasons for the ERCP failure were postsurgical anatomy (n = 7), duodenum stenosis (n = 3), duodenal diverticulum (n = 2), or technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after the i.v. administration of 0.5 IU/kg secretin.
      Results: The MRCP images were diagnostic in all but 1 patient. Five patients gave normal MR fadings and required no further intervention. S-MRCP detected abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilatation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepatico-jejunostomy owing to common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy + Kehr drainage because of narrow biliary-enteric anastomosis; choledocho-jejunostomy, gastro-jejunostomy and Wirsungo-gastrostomy in consequence of chronic pancreatitis or choledocho-jejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage; the indications were choledocholithiasis in one patient choledocho-jejunostomy anastomosis, narrow biliary-enteric anastomosis, or cholangiocarcinoma.
      Conclusion: S-MRCP is the method of choice in cases where ERCP is not possible.
    • Accession Number:
      1393-25-5 (Secretin)
    • Publication Date:
      Date Created: 20040417 Date Completed: 20040617 Latest Revision: 20191210
    • Publication Date:
      20231215
    • Accession Number:
      15085592