Bujanda Luis, Calvo Mari M, Cabriada José L, Orive Victor, Capelastegui Angel
Department of Gastroenterology, San Eloy Hospital, Vizcaya, Spain.
NMR Biomed. 2003 Dec;16(8):475-8. doi: 10.1002/nbm.853.
Postoperative biliary tract lesions are becoming increasingly common. The diagnosis is made by direct cholangiography via endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). The present comparative study evaluates the diagnostic efficacy of magnetic resonance cholangiopancreatography (MRCP) in application to iatrogenic bile duct injury. A prospective blind study was performed, contrasting MRCP and ERCP in 10 patients with suspected postoperative biliary tract lesions. MRCP was performed less than 72 h before ERCP. Final diagnosis was made on the basis of findings at surgery and ERCP. The presence of biliary dilatation, excision injury, stricture, fluid collection and free fluid was analyzed. The mean patient age was 66.5 years. There were three males and seven females. The type of postoperative lesion (Bergman classification) are five patients type C, three type D, one type B and one type A. Diagnostic failure was recorded in two cases with ERCP, while in five patients it was unable to define a therapeutic approach. In contrast, MRCP correctly diagnosed all patients. MRCP is effective in diagnosing postoperative biliary tract lesions, and can help decide the best therapeutic approach.
术后胆道病变正变得越来越常见。诊断通过经内镜逆行胰胆管造影术（ERCP）或经皮肝穿刺胆管造影术（PTC）进行直接胆管造影来做出。本比较研究评估磁共振胰胆管造影（MRCP）在医源性胆管损伤中的诊断效能。进行了一项前瞻性盲法研究，对10例疑似术后胆道病变的患者的MRCP和ERCP进行对比。MRCP在ERCP前不到72小时进行。最终诊断基于手术和ERCP的结果做出。分析了胆道扩张、切除损伤、狭窄、积液和游离液体的存在情况。患者平均年龄为66.5岁。有3名男性和7名女性。术后病变类型（伯格曼分类）为5例C型、3例D型、1例B型和1例A型。ERCP有2例诊断失败，5例无法确定治疗方法。相比之下，MRCP正确诊断了所有患者。MRCP在诊断术后胆道病变方面有效，并且可以帮助确定最佳治疗方法。
