Abstract
Abstract Background Magnetic resonance cholangiopancreatography (MRCP) is an important imaging modality in ruling out choledocholithiasis and thus guide management of patients. However, access to MRI remains limited, which may lead to delays in discharge. Our aim was to analyse the waiting time for inpatient MRCP and its impact on total length-of-stay (LOS). Methods A retrospective cohort study of all consecutive adult inpatients who underwent MRCP in a single surgical unit was conducted from September 2020 to September 2022. Patients being investigated for non-biliary indications including hepato-pancreato-biliary malignancies were excluded. Patient demographics, laboratory results, MRCP indications, results and timestamps from the hospital’s radiology information system were analysed. Peak liver function test (LFT) values before MRCP were used. P-values were calculated using Student T-test. This study was registered with Clinical Quality Project (LanQIP 14736). Results 677 patient has inpatient MRCPs; 22 were excluded. Median age was 66 years (IQR 51-76) and 401 (59.2%) were female. 281 (41.5%) MRCPs were urgent requests. 128 (18.9%) patients were clinically jaundiced and 115 (17.0%) had gallstone pancreatitis. 228 (33.7%) patients had choledocholithiasis on MRCP, of which 192 (84.2%) were known to have gallstones pre-MRCP. Median waiting time for urgent MRCPs from time of order was 1.0 days versus 1.3 for routine requests (p<0.001). Overall, median LOS was 6.7 days (IQR 4.1-10.9). This was 6.1 days (IQR 3.7-10.1) for urgent scans and 7.0 (IQR 4.5-11.5) for routine scans (p=0.106). Conclusions Inpatient MRCP does not significantly delay discharge in our centre. Patients screened for high-risk features of choledocholithiasis should have MRCPs marked as urgent to expedite clinical decision-making and mitigate complications from biliary obstruction. Therefore, it remains useful in determining the need for endoscopic retrograde cholangiopancreatography and/or intra-operative cholangiogram in patients with gallstone disease.
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