0
Sign In  | Subscribe
7 October 2003, Vol 139, No. 7>
Summaries for Patients | 7 October 2003

Noninvasive Diagnosis of Biliary Disease FREE

[+] Article and Author Information

The summary below is from the full report titled “Magnetic Resonance Cholangiopancreatography: A Meta-Analysis of Test Performance in Suspected Biliary Disease.” It is in the 7 October 2003 issue of Annals of Internal Medicine (volume 139, pages 547-557). The authors are J. Romagnuolo, M. Bardou, E. Rahme, L. Joseph, C. Reinhold, and A.N. Barkun.


Ann Intern Med. 2003;139(7):I-32. doi:10.7326/0003-4819-139-7-200310070-00002
Text Size: A A A

What is the problem and what is known about it so far?

Bile is a thick fluid secreted by the liver and stored in the gallbladder. It is then released into the upper intestine to help digest food and break down fats. Bile travels from the liver to the gallbladder and the intestine through canals called ducts. Diseases such as stones and cancer can clog the ducts. Doctors can use several tests to diagnose clogged or obstructed biliary tract ducts. Many are “invasive” tests: They require putting a tube down the patient's mouth, injecting dye through a vein, or inserting a needle into the liver. A relatively new noninvasive test is magnetic resonance cholangiopancreatography (MRCP). This test takes detailed pictures of bile and the biliary tract. Many studies have examined the accuracy of MRCP for diagnosing biliary disease compared with other tests. Do these studies show that MRCP is an accurate test in certain situations and not in others?

Why did the researchers do this particular study?

To summarize results of several studies that looked at how well MRCP detects different types of biliary disease.

Who was studied?

4711 patients who had been in 67 studies comparing MRCP with other tests to detect biliary tract obstruction.

How was the study done?

Rather than do a new study, the authors searched medical literature published from January 1987 through March 2003. They selected published studies if the study compared MRCP with another standard test for detecting biliary disease. Most of the comparison standard tests were invasive procedures. By using a type of analysis called meta-analysis, the authors grouped and combined the results from all of the studies to see whether MRCP was as good as the other tests in detecting certain types of biliary disease.

What did the researchers find?

MRCP was accurate for detecting biliary tract obstruction and compared well with most other tests. It appeared slightly less sensitive for diagnosing stones (92%) and for distinguishing benign from malignant obstruction (87%) than for identifying the presence (99%) and actual site or level (96%) of obstruction.

What were the limitations to the study?

Some reviewed studies had weak designs. Some of the accuracy estimates for detecting different types of biliary disease were imprecise.

What are the implications of the study?

MRCP is an accurate, noninvasive test for diagnosing biliary tract obstruction. It usually correctly identifies the presence and level of obstruction. However, it detects some causes of obstruction better than others. It appears slightly less sensitive in detecting stones and in distinguishing benign from malignant causes of obstruction.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Topic Collections
PubMed Articles
Pre-ERCP Imaging of the Bile Duct and Gallbladder.
Gastrointestinal endoscopy clinics of North America Issue date: 2013 Apr
Early detection of biliary atresia: past, present & future.
Expert review of gastroenterology & hepatology Issue date: 2012 Sep

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)