The Predictive Value Of MRCP On The Difficulty Of Taking Stone During EST

Background and ObjectiveCommon bile duct stones(CBDS)refers to the stones located in the common bile duct,most of which are Bile pigment stone or mixed stones mainly with bile pigments,which are well distributed at the lower end of the common bile duct.The principle and purpose of surgical treatment of CBDS is to remove stone,relieve obstruction,flow unobstructed and prevent infection.Magnetic resonance cholangiopancreatography(MRCP)is a technique that displays the long T2 relaxation time structure by using the weighted T2 weighted pulse sequence.It is a new and non interventional method for diagnosing the diseases of pancreaticobiliary duct,similar to the effect of retrograde cholangiopancreatography.Endoscopic sphincterotomy(EST)is a method of endoscopic therapy developed on the basis of ERCP diagnostic technique.It is inserted into the duodenum through the mouth to the duodenal papilla,and the special nipple incision is used to cut the sphincter of the nipple,so as to achieve a minimally invasive operation for removing gallstones or Ascaris and draining biliary tract,but because the disease itself,anatomy and operative operation is difficult to predict the difficulties.By measuring the relevant results on the image from the magnetic resonance cholangio-pancreatography(MRCP),To explore the relationship and predictive value of these results on the difficulty of taking stone during Endoscopic sphincterotomy(EST).MethodsIn the Affiliated Nanhua Hospital of the University of South China,we retrospectively collect the patients with common bile duct stones from December 2016 to December 2017.Before the treatment of EST,the patients had underwent MRCP.The following relevant indexes of bile pancreatic system on the images of MRCP,including the common bile duct diameter,the separation angle between common bile duct and pancreatic duct,the size of stones,the number of stones,and the location of stones,were measured.Considering the operation time and times as a quantitative index,all of the patients were divided into two groups,the easy and the hard.The relevant indexes of bile pancreatic system of two groups from the images of MRCP were compared and analyzed to explore the application value of some indexes which can forecast the difficulty of taking stone during EST.ResultsThere were 91 cases for EST treatment enrolled.The success rate of EST was 96.7%(88/91).The patients were classified into two groups called group A(thirty cases)which taking stone were diffcult and group B(sixty-one cases)which were easier than group A.The two groups had significant differences in the common bile duct diameter and the size of stones.ConclutionsMRCP may be helpful to predict the difficulty of taking stone during EST and to make the best treatment for patients with common bile duct stones.