MR cholangiopancreatography after unsuccessful or incomplete ERCP

PURPOSE: To assess the value of magnetic resonance (MR) cholangiopancreatography in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessful or did not completely delineate ductal abnormalities. MATERIALS AND METHODS: MR cholangiopancreatography was performed in 37 consecutive patients because ERCP was unsuccessful (n = 20), postsurgical biliary-enteric anatomy was present (n = 10), or evidence of complete pancreatic duct obstruction was found at ERCP (n = 7). RESULTS: MR cholangiopancreatography was successful in all patients. Eleven patients had normal MR findings and required no further intervention. Eight patients had abnormalities that were detected with MR but were followed up clinically. Eleven patients subsequently underwent laparotomy, three underwent ERCP with papillotomy, two underwent therapeutic percutaneous transhepatic cholangiography (ETC), two underwent diagnostic PTC, and one underwent ultrasound-guided biopsy. CONCLUSION: MR cholangiopancreatography plays an important role in the care of patients in whom ERCP is unsuccessful or incomplete and when technical difficulties can be anticipated.