[Utility of magnetic resonance cholangiography, ultrasonography and liver function test in preoperative assessment of patients with symptomatic cholecystolithiasis and suspected biliary obstruction [a comparative study]]

Evaluation of suspected biliary obstruction is performed by common old methods such as Ultrasound, CT, and invasive cholangiography. These techniques have limitations due to the poor visualization of intraductal stones [US, CT] and the need for an invasive procedure [ERCP, PTC]. Magnetic resonance cholangiography [MRC] is noninvasive imaging modality that provides good visualization of the hepatobiliary system. The aim of the present study was to determine the utility of Magnetic resonance cholangiography, Ultrasonography and Liver function test in preoperative assessment of patients with symptomatic cholecystolithiasis and suspected biliary obstruction. Patients selected for elective open cholecystectomy with risk factors of common bile duct stones as suspected biliary obstruction underwent MRC, US, and Liver function test preoperatively. All patients underwent open cholecystectomy and intraoperative cholangiography in Imam Khomeini Hospital, Academic Medical Center of Medicine School, Mazandaran University of Medical Sciences, Sari, Iran from January 2003 to February 2006. 30 patients [11 male, 19 female] with the mean age 53.93 +/- 13.32 years in a range of 38-75 years underwent all preoperative and operative assessments. 81.81% Sensitivity, 87.5% specificity and 83.33% efficacy in MRC; 18.18% Sensitivity, 87.5% specificity and 36.66% efficacy in US, and 54.54% Sensitivity, 37.50% specificity and 50% efficacy in Liver function test were the results obtained for biliary stones. MRC has excellent diagnostic accuracy in the detection of biliary disease. Due to its non-invasive nature, MRI may have advantages over invasive cholangiography when diagnosis is the major goal of the procedure

[ recurrence rate of helicobacter pylori infection 2 years after eradication]

Helicobacter pylori [HP] has an important role in the pathogenesis of gastritis, peptic ulcer and gastric cancer. The eradication of HP results in the prevention of the recurrence of peptic ulcer and its complications. In developed countries, the recurrence of infection is unusual and rare after the successful eradication of HP infection, however it is likely in developing countries and the rate is variable in different parts of the world. The aim of this study was to evaluate the recurrence rate of HP infection, at least 2 years after the successful eradication of HP infection. Those patients with documented duodenal ulcer [according to endoscopy] and HP infection [according to rapid urease test] were included in this study. The patients were treated with different HP eradication regimens and the eradication was proved, using the 14C Urea Breathing Test [UBT]. The patients were re-evaluated with 14C UBT at least 2 years after the first negative UBT result [mean duration: 36 months, ranging from 24 to 30 months]. Eighty patients [51 males and 29 females] were included in the study. Mean age was 40.53 +/- 10.99 Although HP eradication was performed successfully, the recurrence rate was significant. This can influence the therapeutic and the following up strategies of the patients