Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 21 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

Initial MRCP is better for patients with abdominal pain than ERCP

Initial MRCP in patients with abdominal pain could significantly lower patient morbidity and mortality, and also reduce ERCP workload, finds a study in the August issue of Endoscopy.

News image

fiogf49gjkf04

Endoscopic retrograde cholangiopancreatography (ERCP) has a significant mortality, morbidity, and failed cannulation rate. Magnetic resonance cholangiopancreatography (MRCP) is a safer, noninvasive method of imaging the pancreaticobiliary tree.

A substantial number of patients are referred for ERCP because of abdominal pain, a high proportion of whom have normal ducts or pathology not requiring interventional ERCP.

Two teams in Dublin, Ireland, and Boston, Massachusetts, USA, conducted the study. They assessed the potential impact of MRCP on overall ERCP workload and patient outcome, if MRCP were the primary investigation in patients referred for ERCP because of abdominal pain.

Initial MRCP could significantly reduce patient mortality.
Endoscopy
The survey involved 1758 consecutive ERCPs performed in 1148 patients. These were conducted over a 3-year period in a single tertiary referral center in the pre-MRCP era.

Cannulation failure, ERCP findings, need for follow-up ERCP, and all 30-day major complication rates were analyzed, with regard to clinical indications.

The overall workload comprised 1108 (63%) successful initial ERCPs, 188 (11%) failed cannulation attempts, and 462 (26%) follow-up ERCPs.

Of the patients, 299 (27%) had normal ERCP findings, 331 (30%) had choledocholithiasis, and 246 (22%) had strictures.

If MRCP had been used as the primary imaging investigation in the 451 patients (39%) referred for ERCP because of abdominal pain, the research group predicted that 197 patients (44%) would have avoided ERCP. In addition, the overall ERCP workload would have been reduced by 13%.

Initial MRCP in suspected gallstone pancreatitis and certain miscellaneous groups, it was estimated, would have further decreased ERCP workload by 9%.

Furthermore, 4 of 40 major ERCP-related complications and 1 of 4 ERCP-related deaths would potentially have been avoided.

The research group concluded that the relatively small reduction in ERCP workload among these patients reflects the fact that over half of them had probable sphincter dysfunction. A significant proportion of these might have benefited from biliary manometry and/or endoscopic intervention despite a normal MRCP.

Moreover, a small number of patients with calculi and subtle biliary and pancreatic strictures would be missed by this approach.

Endoscopy 2001; 33 (8): 668-75
10 August 2001

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

 21 February 2018 
Management of hemorrhoids in the USA
 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia
 25 January 2018 
Predicting intra-abdominal infections after colorectal surgery
 25 January 2018 
Predictors of gastric cancer risk
 24 January 2018 
Risk factors underlying previously undiagnosed cirrhosis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us