Routine magnetic resonance cholangiopancreatography and intra-operative cholangiogram in the evaluation of common bile duct stones

Introduction: magnetic resonance cholangiopancreatography (MRCP) is a safe and sensitive investigation for the imaging of common bile duct pathology. When used to exclude common bile duct (CBD) stones, MRCP may obviate the need for intra-operative cholangiogram (IOC). In this prospective study, we looked at the single centre results of patients who underwent cholecystectomy with IOC following pre-operative MRCP. Patients and methods Over a period of 18 months, 69 patients (24 male and 45 female; mean age 59 years [range, 19-86 years]) were investigated by MRCP prior to cholecystectomy. All patients underwent IOC. IOC inclusion-criteria for MRCP consisted of derangement of liver function tests and/or history of jaundice in cases of ultrasound proven cholelithasis. Results: Sixteen patients had suspected stones or filling defects on MRCP, all two of these were confirmed to be stones on IOC. In one patient was a stone visulised on IOC and not seen on MRCP. Conclusion: MRCP may be the only pre-operative investigation needed for exclusion of CBD stones, obviating the necessity for IOC.