Abstract
CONTEXTThe usefulness of MRCP in the workup of acute pancreatitis has long been debated.METHODS2013-2016 chart review data were collected by the authors from adult patients with acute pancreatitis who also had received Magnetic Resonance Cholangiopancreatography (MRCP). Those patients were categorized by diagnosis and according to whether or not the MRCP changed healthcare services.RESULTSChanges in care were significantly correlated with diagnosis and elevated liver function tests (LFT). The patients who benefitted most from MRCP were those with acute gallstone pancreatitis (r = 0.298, n = 109, p = 0.002) and patients with elevated LFT (r = 0.219, n = 89, p= 0.040). The most common way that MRCP influenced the care of patients with acute gallstone pancreatitis was by allowing providers to forego intraoperative cholangiogram (IOC) when MRCP results were negative (r = 0.335, n = 109, p < 0.001).CONCLUSIONSThe authors conclude that this was not the most cost effective management practice since the cost of intraoperative cholangiogram was about one quarter that of MRCP. Limiting MRCP use in patients with acute gallstone pancreatitis and preferentially using IOC at the time of surgery can likely decrease hospital costs without compromising care.
Highlights
Magnetic resonance cholangiopancreatography (MRCP) is an expensive study, averaging over $2,000.1 MRCP has long been thought to be a reliable predictor of choledocholithiasis, patient selection criteria for MRCP could potentially be refined to improve its cost-effective use
As intraoperative cholangiogram (IOC) and endoscopic retrograde cholangiopancreatography (ERCP) are less often ordered, the management of common bile duct stones has been found to be more often affected by the availability of instrumentation, personnel and skills rather than cost-effectiveness.[2]
This study group recommended that MRCP in acute biliary pancreatitis should be withheld for at least a week if there is no clinical worsening since many patients with choledocholithiasis will spontaneously pass their stones.[5]
Summary
2013-2016 chart review data were collected by the authors from adult patients with acute pancreatitis who had received Magnetic Resonance Cholangiopancreatography (MRCP). Those patients were categorized by diagnosis and according to whether or not the MRCP changed healthcare services
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
