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Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage

Current non-invasive diagnostic modalities of iatrogenic bile leak (BL) are not particularly sensitive and often fail to localise the BL origin. Percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) are considered the gold standard, yet are invasiv...

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Autores principales: Argirò, Renato, Sensi, Bruno, Siragusa, Leandro, Bellini, Luigi, Conte, Luigi Edoardo, Riccetti, Camilla, Del Vecchio Blanco, Giovanna, Troncone, Edoardo, Floris, Roberto, Salavracos, Mike, Tisone, Giuseppe, Anselmo, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10217083/
https://www.ncbi.nlm.nih.gov/pubmed/37238167
http://dx.doi.org/10.3390/diagnostics13101681
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author Argirò, Renato
Sensi, Bruno
Siragusa, Leandro
Bellini, Luigi
Conte, Luigi Edoardo
Riccetti, Camilla
Del Vecchio Blanco, Giovanna
Troncone, Edoardo
Floris, Roberto
Salavracos, Mike
Tisone, Giuseppe
Anselmo, Alessandro
author_facet Argirò, Renato
Sensi, Bruno
Siragusa, Leandro
Bellini, Luigi
Conte, Luigi Edoardo
Riccetti, Camilla
Del Vecchio Blanco, Giovanna
Troncone, Edoardo
Floris, Roberto
Salavracos, Mike
Tisone, Giuseppe
Anselmo, Alessandro
author_sort Argirò, Renato
collection PubMed
description Current non-invasive diagnostic modalities of iatrogenic bile leak (BL) are not particularly sensitive and often fail to localise the BL origin. Percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) are considered the gold standard, yet are invasive studies with potential complications. Ce-MRCP has been not comprehensively studied in this setting but may prove particularly helpful given its non-invasive nature and the anatomical dynamic detail. This paper reports a monocentric retrospective study of BL patients referred between January 2018 and November 2022 submitted to Ce-MRCP followed by PTC. The primary outcome was the accuracy of Ce-MRCP in detecting and localising BL compared to PTC and ERCP. Blood tests, coexisting cholangitis features and time for leak resolution were also investigated. Thirty-nine patients were included. Liver-specific contrast-enhanced MRCP detected BL in 69% of cases. The BL localisation was 100% accurate. Total bilirubin above 4 mg/dL was significantly associated with false negative results of Ce-MRCP. Ce-MRCP is highly accurate in detecting and localising BL, but sensitivity is significantly reduced by a high bilirubin level. Ce-MRCP may be very useful in early BL diagnosis and in accurate pre-treatment planning, but can only be reliably used in selected patients with TB < 4 mg/dL. Non-surgical techniques, both radiological and endoscopic, are proven to be effective in terms of leak resolution.
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spelling pubmed-102170832023-05-27 Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage Argirò, Renato Sensi, Bruno Siragusa, Leandro Bellini, Luigi Conte, Luigi Edoardo Riccetti, Camilla Del Vecchio Blanco, Giovanna Troncone, Edoardo Floris, Roberto Salavracos, Mike Tisone, Giuseppe Anselmo, Alessandro Diagnostics (Basel) Article Current non-invasive diagnostic modalities of iatrogenic bile leak (BL) are not particularly sensitive and often fail to localise the BL origin. Percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) are considered the gold standard, yet are invasive studies with potential complications. Ce-MRCP has been not comprehensively studied in this setting but may prove particularly helpful given its non-invasive nature and the anatomical dynamic detail. This paper reports a monocentric retrospective study of BL patients referred between January 2018 and November 2022 submitted to Ce-MRCP followed by PTC. The primary outcome was the accuracy of Ce-MRCP in detecting and localising BL compared to PTC and ERCP. Blood tests, coexisting cholangitis features and time for leak resolution were also investigated. Thirty-nine patients were included. Liver-specific contrast-enhanced MRCP detected BL in 69% of cases. The BL localisation was 100% accurate. Total bilirubin above 4 mg/dL was significantly associated with false negative results of Ce-MRCP. Ce-MRCP is highly accurate in detecting and localising BL, but sensitivity is significantly reduced by a high bilirubin level. Ce-MRCP may be very useful in early BL diagnosis and in accurate pre-treatment planning, but can only be reliably used in selected patients with TB < 4 mg/dL. Non-surgical techniques, both radiological and endoscopic, are proven to be effective in terms of leak resolution. MDPI 2023-05-09 /pmc/articles/PMC10217083/ /pubmed/37238167 http://dx.doi.org/10.3390/diagnostics13101681 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Argirò, Renato
Sensi, Bruno
Siragusa, Leandro
Bellini, Luigi
Conte, Luigi Edoardo
Riccetti, Camilla
Del Vecchio Blanco, Giovanna
Troncone, Edoardo
Floris, Roberto
Salavracos, Mike
Tisone, Giuseppe
Anselmo, Alessandro
Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title_full Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title_fullStr Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title_full_unstemmed Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title_short Liver-Specific Contrast-Enhanced Magnetic Resonance Cholangio-Pancreatography (Ce-MRCP) in Non-Invasive Diagnosis of Iatrogenic Biliary Leakage
title_sort liver-specific contrast-enhanced magnetic resonance cholangio-pancreatography (ce-mrcp) in non-invasive diagnosis of iatrogenic biliary leakage
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10217083/
https://www.ncbi.nlm.nih.gov/pubmed/37238167
http://dx.doi.org/10.3390/diagnostics13101681
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