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A Prospective study of Role of Magnetic Resonance Cholangiopancreatography for Prediction of Difficult Cholecystectomy

Rajan Somani, Additional Professor, Dept. of General Surgery, Sir T. Hospital & Govt. Medical College, Bhavnagar, Gujarat 364001, India. , Abdulhamid Khorajiyaa , Rajan Somanib , Samir M. Shahc , Smit Mehtad , Dharmapal Bagatee

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New Indian Journal of Surgery 9(1):p 16-21, Jan-Feb 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.3

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Abstract

Background and Objectives: To identify difficult cholecystectomy is often subjective, because itcan be established by the operator in an arbitrary manner.The followingparameters allow defining cholecystectomy as “difficult”: difficult identification and isolation of the cystic artery and duct, scarring of Calot’striangle, inflammation, Adhesions,a short cysticduct, difficult dissection of the gallbladder wall from the hepatic bed etc. MRCP being an excellent, easily available, safe, noninvasive modality in delineating anatomy of extra hepatic as well as intra hepatic biliary system can be used prior to everycholecystectomy to detect the exact pathology and presence of any anatomical variations. This will preclude the surgeon from coming across any unexpected variations which can lead to serious complications.

Methods: In this study, 50 cases of gallbladder disease are examined preoperatively for difficult cholecystectomy based on MRCP findings in Sir T. Hospital, Bhavnagar from December2015 to September2017.

Results: In this study, difficult cholecystectomy is more found in age group of 4160 years 64.28%, more in male patients 69.23% and more common with jaundice and other associated factors like Hypertension, Diabetes and IHD. Out of 50 patients MRCP of total 41patients were done and can identify the possibility of difficult cholecystectomyin 20 patients.

Conclusion: MRCP preoperatively helps in identifying the difficultcholecystectomy. So we can preoperatively explain the patient regarding complications and methods of operations. We can minimize the intraoperativecomplications, reduce operative time and also we can prevent intraoperativemorbidity of the patients.

 

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.3

Keywords

MRCP; Magnetic Resonance Chaolangiopancreatography; Difficult Cholecystectomy. 

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