Role of MR chlangiopancreatography in biliary obstruction- A clinico-radiologic and opreative study

ABSTRACT

Thirty-five patients with obstructive jaundice suspected clinically [19 males and 16 females, their ages ranged from 5 to 81 years] were included in this study. All patients were subjected to complete medical history, full clinical examination, biochemical study [liver function tests and hepatitis markers], abdominal US and magnetic resonance cholangiopancreatography [MRCP]. Twenty-three patients were operated upon. ERCP was done in nine patients as well as percutaneous transhepatic cholangiography [PTC] and drainage transhepatic cholangiography [PTD] in two patients. One patient was diagnosed by ultrasound [US] and MRCP to have primary sclerosing cholangitis. MRCP images revealed extrahepatic biliary obstruction in 34 cases with good quality images. It demonstrated the levels of obstruction in all patients but diagnosed their causes in 33 only [16 were malignant, 11 calcular, one primary sclerosing cholangitis, 3 post-cholecystectomy stricture of CBD, one papillary stenosis and one chronic pancreatitis]. In two patients, there was a distal obstruction of undetermined origin by MRCP and one patient had calcular obstruction by ERCP [false -ve]