Effectiveness of pre-operative routine MRCP in patients scheduled for laparoscopic cholecystectomy

Abstract

Background: Cholelithiasis is one of the most common surgical diseases worldwide. Laparoscopic cholecystectomy is the gold standard treatment for cholelithiasis, and has become the most common performed gastro intestinal operation. The prevalence is higher in women (7.7%) than in men (3.3%). We aimed to investigate the effectiveness of pre-routine magnetic resonance cholangiopancreatography (MRCP) before performing scheduled Laparoscopic cholecystectomy. Methods: This was a prospective observational study conducted in the Department of General Surgery, Dhaka Central International Medical College, and selected single private Hospital from Dhaka, Bangladesh during the period from January 2021 to January 2023. In our study, we included 90 female patients presented with acute or chronic calculus cholecystitis. All patients were diagnosed with multiple gall stones diseases on USG abdomen after initial clinical evaluation were included in this study. Result: In our study, we found the mean age was 34.97±8.48 years. Among 90 patients USG showed multiple stones in 85(94.44%) patients whereas, MRCP showed stones only in 24 (26.67%) patients. Among patients with normal CBD, MRCP found 25.33 % and USG found 93.33% with stones. There were 3 patients with more than 5 mg/dl. bilirubin who was diagnosed with stones in both findings. Among the patients with 148-220 ALP levels, both USG and MRCP found 90.48% of patients with stones. We found 1 true negative case and 20 true positive cases of multiple stones (with a p value of 0.017). Conclusion: We found that MRCP helps increase the safety of perioperative management in some cases. Preoperative ultrasonography has a low diagnostic accuracy rate when it comes to patients who also have gallstones and CBD stones. So, individuals with gallstones are advised to undergo a normal preoperative MRCP examination.