Researchers from Miami, Florida, USA, assessed the role of MR cholangiopancreatography (MRCP) in the evaluation of iatrogenic bile duct injuries.
MRCP was performed in 10 postoperative patients (9 female and 1 male, ranging in age from 17 to 79 years) suspected of having bile duct injury as a result of surgery.
Presence or absence of biliary dilatation, excision injury, stricture, fluid collection, and free fluid was noted.
Excision injury was diagnosed if a segment of bile duct was not visible on any of the MRCP sequences.
The positive cases were classified according to anatomic location and extent of injury.
The researchers compared the results with endoscopic retrograde cholangiopancreatography in 5 patients, percutaneous transhepatic cholangiography in 1, surgery in 4, and clinical follow-up in 3.
| MRCP can diagnose, characterize, and classify iatrogenic bile duct injuries.
| American Journal of Roentgenology |
It was found that 3 patients had normal findings on MRCP and remained asymptomatic on clinical follow-up.
Some 4 patients had bile duct excision injury on MRCP that was surgically proven, and 1 had stricture, confirmed by percutaneous transhepatic cholangiography.
Of these 5 patients, 1 had Bismuth type I injury, 2 had type II, 1 had type III, and 1 had type IV.
The team found that 2 patients had findings suggestive of cystic duct leak on MRCP that were confirmed on cholangiography.
Tahir R. Khalid, of the University of Miami School of Medicine, said on behalf of fellow authors, "MRCP can accurately diagnose postoperative biliary strictures and excision injuries, and can characterize and anatomically classify these injuries for planning reparative surgery."
"It can also suggest the presence of cystic duct leaks in patients who have undergone cholecystectomy," it was concluded.