MR CHOLANGIOPANCREATOGRAPHY AFTER UNSUCCESSFUL OR INCOMPLETE ERCP

PURPOSE: To assess the value of magnetic resonance (MR) cholangiopancr eatography in patients in whom endoscopic retrograde cholangiopancreat ography (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 patie nts. Eleven patients had normal MR findings and required no further in tervention. Eight patients had abnormalities that were detected with M R but were followed up clinically. Eleven patients subsequently underw ent laparotomy, three underwent ERCP with papillotomy, two underwent t herapeutic percutaneous transhepatic cholangiography (ETC), two underw ent diagnostic PTC, and one underwent ultrasound-guided biopsy. CONCLU SION: MR cholangiopancreatography plays an important role in the care of patients in whom ERCP is unsuccessful or incomplete and when techni cal difficulties can be anticipated.