The Integrative Role of Magnetic Resonance Cholangiopancreatography and Percutaneous Transhepatic Cholangiography in Malignant Obstructive Jaundice

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) andpercutaneous trans-hepatic cholangiography (PTC) are established techniques for the evaluation of intra-hepatic and extra-hepatic bile ducts in patients with malignant hepato-biliary diseases. PTC has procedure-related complications. MRCP is accurate, non-invasive and safe. Objective: To evaluate the role of magnetic resonance cholangiopancreatography (MRCP) and percutaneous transhepatic cholangiography (PTC) in the diagnosis of malignant biliary obstruction. Patients and Methods: This study was conducted on 30 patients (18 males and 12 females) with malignant obstructive jaundice. Their ages ranged between 36 and 85 years with a mean age of 59.9 years. All the 30 examined cases in our study were subjected to MRCP and PTC to detect the diagnosis, the level of obstruction and the degree of obstruction. Results: Both MRCP and PTC were accurate in the detection of the malignant biliary dilatation and the level of obstruction. MRCP provided adequate information in the diagnosis of the malignant lesions with sensitivity of 86.6% with low sensitivity to detect the degree of obstruction weather complete or partial 12.5% compared to PTC. MRCP detected other related malignant features in 40% of cases. PTC-related complications in 6 out of 30 cases (20%). In 6 patients more than one puncture had to be performed during PTC to delineate the whole biliary system. Conclusion: MRCP is accurate and non-invasive procedure for the diagnosis of the malignant obstructive jaundice and the level of biliary obstruction reserving PTC for therapeutic procedures and pre-surgical assessment of the degree of obstruction.