Literature DB >> 18209782

Postprocedural interpretation of endoscopic retrograde cholangiopancreatography by radiology.

Nitin Khanna1, Gary May, Sydney Bass, Marty Cole, Joseph Romagnuolo.   

Abstract

BACKGROUND: With the increase in the use of endoscopic retrograde cholangiopancreatography (ERCP) (necessitating real-time interpretation), it is unknown whether post-ERCP radiologist reporting is still necessary or helpful.
OBJECTIVES: To determine the rate of discrepancy of results, and the rate of clinically relevant misses and additions, by the radiology report in a blinded setting.
METHODS: A retrospective analysis of the procedure and blinded postprocedure radiology reports of 100 consecutive ERCP cases was performed. A list of clinically relevant pathology and subgroups was made a priori. Discrepancies are described as proportions, with 95% CIs. The radiology yield regarding pathology that was clearly demonstrated at ERCP (bile leaks and stones removed) was calculated. Clinical follow-up was used to clarify additional abnormalities reported by radiology.
RESULTS: Clinically relevant discrepancies in report pairs occurred in 29.0% of cases (95% CI 20% to 39%), or 40.0% if discrepancies regarding bile duct dilation are considered (95% CI 30% to 50%). In 15 of 30 cases (50.0% [95% CI 31% to 69%]) in which bile duct stones were removed, the radiologist did not report a stone. The radiologist did not report five of eight bile leaks (62.5% [95% CI 24% to 91%]). In seven cases (7.0% [95% CI 2.9% to 13.9%]), an additional abnormality was noted by radiology, including a biliary stricture, bile duct and pancreatic duct stones, as well as sclerosing cholangitis. However, during a mean follow-up period of 5.6 months, it appeared that these radiology interpretations were likely incorrect. Discrepancy rates did not vary among the ERCP attendings or by radiology volume.
CONCLUSIONS: Discrepancies between endoscopists' and radiologists' ERCP reports are common. Blinded radiology interpretation frequently misses important pathology, and falsely positive additional diagnoses may be made.

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Mesh:

Year:  2008        PMID: 18209782      PMCID: PMC2659121          DOI: 10.1155/2008/751950

Source DB:  PubMed          Journal:  Can J Gastroenterol        ISSN: 0835-7900            Impact factor:   3.522


  10 in total

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Authors:  M L Freeman; D B Nelson; S Sherman; G B Haber; M B Fennerty; J A DiSario; M E Ryan; P P Kortan; P J Dorsher; M J Shaw; M E Herman; J T Cunningham; J P Moore; W B Silverman; J C Imperial; R D Mackie; P A Jamidar; P N Yakshe; G M Logan; A M Pheley
Journal:  Gastrointest Endosc       Date:  1999-05       Impact factor: 9.427

2.  The impact of post-procedure interpretation of ERCP X-ray films by radiologists on patient care: should it be routine or selective?

Authors:  John T Sweeney; Raj J Shah; Stephen P Martin; Charles D Ulrich; Lehel Somogyi
Journal:  Gastrointest Endosc       Date:  2003-10       Impact factor: 9.427

3.  Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study.

Authors:  S Loperfido; G Angelini; G Benedetti; F Chilovi; F Costan; F De Berardinis; M De Bernardin; A Ederle; P Fina; A Fratton
Journal:  Gastrointest Endosc       Date:  1998-07       Impact factor: 9.427

4.  Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatography.

Authors:  M G Lee; H J Lee; M H Kim; E M Kang; Y H Kim; S G Lee; P N Kim; H K Ha; Y H Auh
Journal:  Radiology       Date:  1997-03       Impact factor: 11.105

5.  Risk factors for post-ERCP pancreatitis: a prospective, multicenter study.

Authors:  M L Freeman; J A DiSario; D B Nelson; M B Fennerty; J G Lee; D J Bjorkman; C S Overby; J Aas; M E Ryan; G S Bochna; M J Shaw; H W Snady; R V Erickson; J P Moore; J P Roel
Journal:  Gastrointest Endosc       Date:  2001-10       Impact factor: 9.427

6.  Patterns of use of endoscopic retrograde cholangiopancreatography in a Canadian province.

Authors:  Robert J Hilsden; Joseph Romagnuolo; Gary R May
Journal:  Can J Gastroenterol       Date:  2004-10       Impact factor: 3.522

7.  Choledocholithiasis: evaluation of MR cholangiography for diagnosis.

Authors:  C Reinhold; P Taourel; P M Bret; G A Cortas; S N Mehta; A N Barkun; L Wang; F Tafazoli
Journal:  Radiology       Date:  1998-11       Impact factor: 11.105

8.  Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography.

Authors:  J A Soto; M A Barish; E K Yucel; D Siegenberg; J T Ferrucci; R Chuttani
Journal:  Gastroenterology       Date:  1996-02       Impact factor: 22.682

9.  Endoscopic ultrasonography versus cholangiography for the diagnosis of choledocholithiasis.

Authors:  M I Canto; A Chak; T Stellato; M V Sivak
Journal:  Gastrointest Endosc       Date:  1998-06       Impact factor: 9.427

10.  Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected common-bileduct lithiasis.

Authors:  F Prat; G Amouyal; P Amouyal; G Pelletier; J Fritsch; A D Choury; C Buffet; J P Etienne
Journal:  Lancet       Date:  1996-01-13       Impact factor: 79.321

  10 in total
  1 in total

1.  Controversies in ERCP: Technical aspects.

Authors:  Christoph F Dietrich; Noor L Bekkali; Sean Burmeister; Yi Dong; Simon M Everett; Michael Hocke; Andre Ignee; Wei On; Srisha Hebbar; Kofi Oppong; Siyu Sun; Christian Jenssen; Barbara Braden
Journal:  Endosc Ultrasound       Date:  2022 Jan-Feb       Impact factor: 5.628

  1 in total

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