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MRCP and ERCP in the diagnosis of common bile duct stones

      Common bile duct stones have been reported to occur in up to 15% of patients with symptomatic gallstones.
      • Ahrendt SA
      • Pitt HA.
      Biliary tract.
      Although the sensitivity of abdominal US for cholelithiasis or gallbladder stones is in excess of 95%,
      • Cooperberg PL
      • Burhenne HJ.
      Real-time ultrasonography. Diagnostic technique of choice in calculous gallbladder disease.
      • Crade M
      • Taylor KJW
      • Rosenfield AT
      • de Graaff CS
      • Minihan P.
      Surgical and pathologic correlation of cholecystosonography and cholecystography.
      • McIntosh DMF
      • Penney HF.
      Gray scale ultrasonography as a screening procedure in the detection of gallbladder disease.
      reported sensitivities of US for common duct stones range from 18% to 74%.
      • Laing FC.
      The gallbladder and bile ducts.
      • Mitchell SE
      • Clark RA.
      A comparison of computed tomography and sonography in choledocholithiasis.
      This variable sensitivity is related in part to the operator-dependent nature of US and the obscuration of stones by bowel gas. Sensitivities of conventional CT in the setting of suspected choledocholithiasis range from 76% to 90%.
      • Baron RL.
      Common bile duct stones: reassessment of criteria for CT diagnosis.
      • Jeffrey RB
      • Federle MP
      • Laing FC
      • Wall S
      • Rego J
      • Moss AA.
      Computed tomography of choledocholithiasis.
      In a preliminary report, unenhanced helical CT has been shown to have a sensitivity of 88%, a specificity of 97%, and an accuracy of 94% in the diagnosis of common bile duct stones.
      • Neitlich JD
      • Topazian M
      • Smith RC
      • Gupta A
      • Burrell MI
      • Rosenfield AT.
      Detection of choledocholithiasis: comparison of unenhanced helical CT and endoscopic retrograde cholangiopancreatography.
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