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Diagnostic role of secretin-enhanced MRCP in patients with unsuccessful ERCP

查看全文 作　　者：László [1]Czakó;Tamás [1]Takács;Zita [2]Morvay;László [2]Csernay;János [1]Lonovics 高影响力作者 机构地区：[1]First Department of Medicine,University of Szeged,Szeged,Hungary;[2]International Medical Center,Szeged,Hungary高影响力机构 出　　处：《World Journal of Gastroenterology》索引2004年第10卷第20期,共5页高影响力期刊 基　　金：Supported by the ETT 5K503 and the Hungarian Academy of Sciences,B 5/2003 摘　　要：AIM: To evaluate the value of MR cholangiopancreatography (MRCP) in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessfully performed by experts in a tertiary center. METHODS: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n=8),suspected chronic pancreatitis (n = 2), recurrent acute pancreatitis (n = 2), or suspected pancreatic cancer (n=1). The reasons for the ERCP failure were the postsurgical anatomy (n = 7), duodenal stenosis (n = 3), duodenal diverticulum (n = 2), and technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after i.v. administration of 0.5 IU/kg secretin.RESULTS: The MRCP images were diagnosed in all 21patients. Five patients gave normal MR findings and required no further intervention. MRCP revealed abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepaticojejunostomy in consequence of common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy+Kehr drainage because of insufficient biliary-enteric anastomosis; choledochojejunostomy, gastrojejunostomy and cysto-Wirsungo gastrostomy because of chronic pancreatitis, orcholedo chojejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage. The indications were choledocholithiasis with choledochojejunostomy, insufficient biliary-enteric anastomosis, or cholangiocarcinoma. CONCLUSION: MRCP can assist the diagnosis and management of patients in whom ERCP is not possible. 关 键 词：诊断 MRCP ERCP 内泌素 胰腺癌 肿瘤
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