tag:blogger.com,1999:blog-2760353953251845523.post446760391137953163..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: MRCP: Stop Already.Jeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-2760353953251845523.post-12765003781880184292013-08-15T09:44:58.966-04:002013-08-15T09:44:58.966-04:00I have found MRCP to be most useful when ever we a...I have found MRCP to be most useful when ever we are suspecting a stone in the CBD. I must confess that I have not been used to IOC in routine cholecystectomies. <br />MRCP if done on a high resolution machine gives excellent idea about the presence/absence of CBD stone as well as the so called "road map".Rahul Singhhttp://www.mcqsurgery.comnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-12348586617521871482013-03-24T18:47:21.110-04:002013-03-24T18:47:21.110-04:00This study was performed at our institution and ar...This study was performed at our institution and argues for the selective use of IOC as compared to routine. It's retrospective data, but I think it was a well-done study and it actually caused some of our surgeons to change their practice patterns (from routine to selective use of IOC), mostly based on our surprisingly high percentage of false-positives on routine IOC. What do you think?<br /><br />http://www.ncbi.nlm.nih.gov/pubmed/22000195Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-70405536699312341702013-03-24T07:17:26.896-04:002013-03-24T07:17:26.896-04:00Anon-
I'm not sure what you mean by incidental...Anon-<br />I'm not sure what you mean by incidental stone. If you mean an IOC that shows questionable filling defect, then follow patient clinically, check LFT's in AM. <br /><br />Uzer-<br />ERCP failure usually occurs <1-5% of the time. I have yet to seen it. I have seen patients with multiple large CBD stones that were unable to be cleared after multiple ERCP's and I had to take back for open CBDE a few times. <br /><br />Also, don't forget laparoscopic transcystic duct CBD stone clearance. Any time you have a seemingly wide caliber cystic duct, always consider sliding as fogarty balloon downstream. It's worked for me maybe a dozen times in my career. Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-38798771932615489672013-03-24T01:19:32.108-04:002013-03-24T01:19:32.108-04:00What if they can't cannulate the duct post op?...What if they can't cannulate the duct post op? Back to OR? Has that happened much to you? Uzerhttps://www.blogger.com/profile/07391069306423383892noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-13463274442269923502013-03-23T21:20:52.376-04:002013-03-23T21:20:52.376-04:00What's your practice when you see a possible &...What's your practice when you see a possible "incidental" stone in the common duct? Anonymousnoreply@blogger.com