[What is the value of ERCP in the era of MRCP?]

The diagnostic approach in patients suspicious for gallstone disease is represented by two main methods--ERCP and MRCP. The magnetic resonance cholangio-pancreatography is safe and precise method of imaging diagnostics, while the endoscopy combines both good diagnostic and therapeutic possibilities.

223 patients were enrolled, 68 of theme were with diagnosed cholestasis and endoscopic sphincterotomy, which was therapeutic in 53 cases. In all patients this condition has been diagnosed using MRCP--in 51 cases choledocholithiasis was diagnosed; 11 were with tumor obstruction; in 6 cases no mechanical cause was found. ERCP was performed on 62 patients with following therapeutical sphincterotomy.

All 223 with performed cholecystectomy were with rate of conversion of 3% and hospital stay--3 days. There were no cases of pancreatitis after the sphincterotomy or hemorrhages requiring hemotransfusion.

Algorithm including MRCP with performing endoscopic sphincterotomy is safe and effective in the diagnostic and treatment of choledocholithiasis. MRCP can be applied in addition to ERCP and IOC.