Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

MRCP-first vs ERCP-first approach in suspected biliary obstruction due to bile duct stones

The most recent issue of the Alimentary Pharmacology & Therapeutics compares MRCP-first vs ERCP-first approach in patients with suspected biliary obstruction due to bile duct stones.

News image

The preferred initial investigation with either magnetic resonance (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) in patients with suspected biliary obstruction remains controversial in many clinical settings.

Dr Barkun and colleagues assessed the effectiveness of an initial MRCP vs. ERCP in the work-up of patients at moderate likelihood of a suspected biliary obstruction.

Patients with an unconfirmed benign biliary obstruction, based on laboratory and ultrasound findings, were randomized to an ERCP-first or MRCP-first strategy, stratified by level of obstruction.

50% in the MRCP-first group ended up avoiding an ERCP in follow-up
Alimentary Pharmacology & Therapeutics

The research team's primary outcome was the occurrence of a disease or procedure-related bilio-pancreatic adverse events within the next 12 months.

Secondary outcomes were the number of subsequent bilio-pancreatic procedures, duration of hospitalisation, days away from activities of daily living, quality of life (SF-36) and mortality.

The researchers randomized 126 patients to ERCP-first, and 131 to MRCP-first.

In follow-up, 14% of ERCP-first, and 19% MRCP-first patients experienced a procedure- or disease-related complication.

A cause of biliary obstruction was found in 40% vs. 50% of patients.

The research team found that 50% of patients in the MRCP-first group ended up avoiding an ERCP in follow-up.

The researchers noted that ERCP-first and MRCP-first patients were away from usual activities for 3 days, and 2 days, respectively.

Dr Barkun's team concludes, "A strategy of MRCP-first decreased the need for subsequent MRCPs, but not complications."

"Further study is required to define factors influencing the eventual use of MRCP vs. ERCP in appropriately selected patients."

Aliment Pharmacol Ther 2013: 38(9): 1045–1053
16 October 2013

Go to top of page Email this page Email this page to a colleague

 23 September 2014

Advanced search
 23 September 2014 
Recurrence of Barrett's neoplasia after resection
 23 September 2014 
Abnormal prion protein in appendixes
 23 September 2014 
Upper GI bleeding with drug combinations
 22 September 2014 
Anorectal function after low anterior resection
 22 September 2014 

Anorectal stricture in Crohn's

 22 September 2014 
Malignancies in celiac disease
 19 September 2014 
Adhesions in abdominal and pelvic surgery
 19 September 2014 
Repeat colonoscopy among US Medicare
 19 September 2014 
Progression to liver cancer in HCV-infected Veterans
 18 September 2014 
Patient improvement following sacral neuromodulation
 18 September 2014 
Autoimmune diseases in functional gastrointestinal disorders
 18 September 2014 
New diagnostic score for hepatic steatosis
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 12 September 2014 
Management of complex colon polyps
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease
 03 September 2014 
Predictors of response in Crohn's disease
 03 September 2014 
Diagnosis of atrophic gastritis
 03 September 2014 
Safety of reinitiation of infliximab therapy
 02 September 2014 
SSRIs and depression in Hep C
 02 September 2014 
Bariatric surgery for obesity
 02 September 2014 
Eosinophilic esophagitis in adults
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 28 August 2014 
Predictoris of C. diff in out-patients
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us