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Revista Colombiana de Cirugía

versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107

Resumo

LEAL, Carlos Alberto et al. Efficacy of cholangiopancreatograghy by magnetic resonance in the diagnosis of choledocholithiasis of intermediate probability. rev. colomb. cir. [online]. 2019, vol.34, n.1, pp.37-44. ISSN 2011-7582.  https://doi.org/10.30944/20117582.96.

Introduction:

Patients with intermediate probability of choledocholithiasis exhibit a highly morbid pathology due to the risk of developing pancreatitis and cholangitis; it demands the study of the bile duct for appropriate diagnostic and therapeutic approach. Currently, the gold standard for its diagnosis and treatment is an invasive examination, ERCP, which not always ends with positive diagnosis of choledocholithiasis, exposing the patient to the associated risks. This is why magnetic resonance cholangiopancreatography has acquired importance in the diagnosis, for it is a non-invasive procedure with lesser risk of complications. For this reason we decided to evaluate its use in mid-probability choledocholithiasis.

Methods:

A study of the diagnostic tests was carried out in a sample of 151 patients with intermediate probability of choledocholithiasis at our center, Fundación Salud El Bosque (Bogotá, Colombia), in the period 2012-2015.

Results:

A total of 151 patients with the diagnosis of choledocholithiasis of intermediate probability were included, evaluating the characteristics of the MRCP, which showed sensitivity of 88%, specificity 79%, PPV88% and NPV 96%, with an accuracy index of 94.7%.

Conclusions:

MRCP is a test that exhibits adequate performance in the evaluation of patients with intermediate probability of choledocholithiasis, avoiding the performance of ERCP. It confirms its previous use when faced with mid-chance choledocholithiasis. The diagnostic impact of dilation of the bile duct and other alterations of the liver profile can not be established with this study.

Palavras-chave : Magnetic resonance cholangiopancreatography; choledocholithiasis; retrograde endoscopic cholangiopancreatography; endoscopic ultrasonography.

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