ABSTRACT
This work aimed to compare the value of MRCP versus ERCP in diagnosis and management of patients with suspected biliary and pancreatic diseases. The study carried out on 20 patients [12 males and 8 females] with obstructive jaundice. Their ages ranged between 25- 66 years with a mean age 44.2-year. Every patient was examined clinically, laboratory and by different imaging modalities. MRCP and ERCP were done for all 20 patients. Both of these investigations diagnose the cases of obstruction in 19 patient out of 20 cases 95%. The level of obstruction was correctly identified in all 20 cases 100%. MRCP diagnose stone in CBD in 5 cases with accuracy of 95%. There is false negative case by MRCP [There is obstruction but the cause is unknown]. Also ERCP diagnose 6 cases of stone CBD with accuracy of 100% compared with final diagnosis [surgery]. During ERCP therapeutic intervention and stone extraction by Dormia basket were occurred. Also MRCP and ERCP diagnose 6 cases of malignant obstruction with false positive case with accuracy of 95%, 2 cases of cholangio-carcinoma of Rt, Lt. hepatic duct, 2cases of periampullary Carcinoma and 2 cases of cancer head pancreas, There is one case of cancer head found to be chronic pancreatitis during surgery. MRCP diagnose benign strictures of extrahepatic ducts in 4 cases with accuracy of 100% ERCP diagnose 3 cases with accuracy of 95%. It failed to diagnose one case of stricture of CHD and history of gastric tube and choledoduodenostomy. It failed because the tube was wide enough that made its filling with the dye infeasible, So MRCP is superior to ERCP in patients with history of biliary enteric, anastmosis where ERCP can not be done. Also MRCP and ERCP diagnose 4cases iatrogenic postcholecystectony ligation of CBD with similar accuracy of 100%. ERCP has complication during this study pancreatitis in 25%, fever in 10% bleeding in 10% also one patient with periampullary adenocarcinoma die before surgery because of cholangitis and hepatorenal syndrome. There is no complication occurrred after MRCP. We conclude that MRCP is evolving rapid, accurate and non-invasive means of evaluating the biliopancreatic ductal system that can provide nearly similar diagnostic information about biliary obstruction as provided with ERCP even in old and debeSlitated patients, Accordingly we can restrict the use of ERCP to cases in which therapeutic procedure are anticipated or MRCP findings are equivocal, wilh considerable saving time and risks to the patients