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Invited Critique: Comparison of Magnetic Resonance and Endoscopic Retrograde Cholangiopancreatography in Malignant Pancreaticobiliary Obstruction: Invited Critique
Michael G. Sarr, MD
Mayo Medical School
Division of General and Gastrointestinal Surgery
Gastroenterology Research Unit (AL 2-435)
Mayo Clinic
200 First St SW
Rochester, MN 55905
Arch Surg. 1999;134:1007.
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In the past 3 decades we have witnessed the introduction of multiple new imaging techniques: endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography, transcutaneous ultrasonography, computed tomography (CT), and, most recently, endoscopic ultrasonography and magnetic resonance cholangiopancreatography (MRCP). All techniques have their proponents, and each has inherent advantages and limitations. Currently, there seems to be no universally accepted consensus on the imaging procedure-of-choice in patients with presumed or suspected mechanical biliary obstruction, as either a diagnostic or a staging procedure.
Georgopoulos and colleagues from Memorial Sloan-Kettering Cancer Center, New York, NY, suggest that MRCP might be the optimal diagnostic test (ie, the safest test, with high sensitivity, specificity, and positive predictive value) and should replace ERCP—and I believe they are correct, although this study does not prove it. Results of their preliminary study (only 18 patients) suggest that the noninvasive MRCP is as accurate as the invasive . . . [Full Text of this Article]
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Comparison of Magnetic Resonance and Endoscopic Retrograde Cholangiopancreatography in Malignant Pancreaticobiliary Obstruction
Steve K. Georgopoulos, Lawrence H. Schwartz, William R. Jarnagin, Hans Gerdes, Ira Breite, Yuman Fong, Leslie H. Blumgart, and Robert C. Kurtz
Arch Surg. 1999;134(9):1002-1007.
ABSTRACT
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