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Guo X, Fan Q, Guo Y, Li X, Hu J, Wang Z, Wang J, Li K, Zhang N, Amin B, Zhu B. Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC. BMC Gastroenterol 2024; 24:28. [PMID: 38195417 PMCID: PMC10777623 DOI: 10.1186/s12876-023-03117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND In the past quite a long time, intraoperative cholangiography(IOC)was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patients undergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. METHODS According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. RESULTS Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCP were higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in non-MRCP group (8.43%) was significantly higher (P < 0.05) than that in MRCP group (0%). There was no significant difference in hospital stay (P > 0.05), but there was significant difference in hospitalization expenses (P < 0.05) between the two groups. According to the stratification of gallbladder stone patients with CBDS, hospital stay and hospitalization expenses were compared, and there was no significant difference between the two groups (P > 0.05). CONCLUSIONS The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.
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Affiliation(s)
- Xu Guo
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Qing Fan
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Yiman Guo
- School of Clinical Medicine, Hebei University, Wusi East Road 180th, Lianchi District, Hebei Province, 071000, Baoding City, China
| | - Xinming Li
- Department of Urology, Fuyang People's Hospital, Anhui Medical University, Sanqing Road 501th, Ying Zhou District, 236012, Fuyang City, Anhui Province, China
| | - Jili Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, 450052, Zhengzhou City, Henan Province, China
| | - Zhuoyin Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Jing Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Kai Li
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Nengwei Zhang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Buhe Amin
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China.
| | - Bin Zhu
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China.
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