Percutaneous transhepatic cholangiography in the era of magnetic resonance cholangiopancreatography: A prospective comparative analysis in preoperative evaluation of benign biliary stricture. Issue 7 (23rd June 2021)

• Record Type: Journal Article
• Authors: Kurdia, Kailash C; Irrinki, Santhosh; Siddharth, Bharath; Gupta, Vikas; Lal, Anupam; Yadav, Thakur D
• Is Part Of: JGH open. Volume 5:Issue 7(2021)
• Page Start: 820
• Page End: 824
• Publication Date: 2021-06-23
• Subjects: benign biliary stricture -- cholecystectomy -- magnetic resonance cholangiopancreatography -- percutaneous transhepatic cholangiography -- Roux‐en‐Y hepatico‐jejunostomy
• DOI: 10.1002/jgh3.12594
• Languages: English
• ISSNs: 2397-9070

Abstract

Abstract: Background and Aim: Accurate anatomical delineation is the key before definitive repair for benign biliary stricture (BBS). The role of percutaneous transhepatic cholangiography (PTC) as a road map is less studied in the era of magnetic resonance cholangiopancreatography (MRCP). Methods: A prospective observational study, performed between July 2012 and December 2013. All patients of post‐cholecystectomy BBS were evaluated with MRCP and PTC prior to definitive repair. Findings of MRCP and PTC were compared with intraoperative details. Results: Thirty patients with BBS were included in the study. MRCP was performed in all but PTC was amenable in 28 of 30 (93.3%) patients. PTC was comparable to MRCP in diagnosing stricture type (96.4% vs 89.3%), intrahepatic stones (75% vs 75%), and biliary anomalies (95.6% vs 100%). Additionally, PTC revealed internal biliary fistula in 4 (85.7% vs 61.4%; P value 0.04). PTC‐related minor complications were noted in 2 (7.1%) patients. Conclusion: PTC is comparable to MRCP in diagnosing the stricture type, intrahepatic biliary stones, and biliary anomalies. Though comparable to MRCP, the authors could not reveal any additional information that could change the course of management in BBS. Abstract : Magnetic resonance cholangiopancreatography (MRCP) appears to be an optimum preoperative roadmap, as it yielded additional information like collections or intra‐abdominal abscess for deciding the management in benign biliary stricture (BBS). MRCP has been found to be inferior to percutaneous transhepatic cholangiography (PTC) in recognizing internal biliary fistulae. PTC was more in concordance with the intraoperative findings with respect to the type of stricture when compared with MRCP. Though PTC yielded some additional information over MRCP, it could not alter the course of management in BBS.