{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:24:08Z","timestamp":1792632248369,"version":"4.5.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>Laparoscopic cholecystectomy remains one of the most common surgical operations. Common bile duct stones (CBDS) are estimated to be present in 10%-20% of individuals with symptomatic gallstones. Preoperative magnetic resonance cholangiopancreatography (MRCP) and intraoperative cholangiography (IOC) remain the most common methods of evaluation, with subsequent endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction if positive for CBDS. We examined our experience with preoperative MRCP versus IOC for the management of the jaundiced patient with cholelithiasis. This is a retrospective single-institution study that examined all laparoscopic cholecystectomies performed over a 15-month period between 2017 and 2018. Outpatient elective cases were excluded from the analysis. Charts were reviewed for demographics, operative details, and whether an MRCP, IOC, or ERCP was performed. Data were evaluated using a 2-sample t-test. A total of 460 patients underwent laparoscopic cholecystectomy over a 15-month period. Of those, 147 underwent either an MRCP or an IOC for clinical suspicion for CBDS. ERCP after MRCP was nontherapeutic in 11\/32 (34%) compared with 2\/12 (17%) of patients following IOC. The sensitivity and specificity of MRCP were 91% and 80%, respectively, with a positive predictive value of 66% and a negative predictive value of 96%. The sensitivity and specificity of IOC were 83% and 97%, respectively, with a positive predictive value of 83% and a negative predictive value of 97%. MRCP and IOC have unique advantages and disadvantages. MRCP has greater sensitivity, but poor specificity, resulting in unnecessary ERCPs with associated morbidity and increased costs to the patient.<\/jats:p>","DOI":"10.1177\/0003134820942139","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T14:47:39Z","timestamp":1597762059000},"page":"1022-1025","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Overall Poor Specificity of MRCP in the Preoperative Evaluation of the Jaundiced Patient Will Increase the Incidence of Nontherapeutic ERCP"],"prefix":"10.1177","volume":"86","author":[{"given":"Andrew M.","family":"O\u2019Neill","sequence":"first","affiliation":[{"name":"Department of Surgery, Mountain Area Health Education Center (MAHEC), Asheville, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mountain Area Health Education Center (MAHEC), Asheville, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorinda K.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Research, UNC Health Sciences at Mountain Area Health Education Center (MAHEC), Asheville, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Schurr","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mountain Area Health Education Center (MAHEC), Asheville, NC, USA"},{"name":"Department of Surgery, Mission Hospital, Asheville, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"bibr1-0003134820942139","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2012.6.2.172"},{"key":"bibr2-0003134820942139","doi-asserted-by":"crossref","unstructured":"Barnes DS.\n                      Gallbladder and Biliary Tract Disease\n                      , Cleveland Clinic. 2010. Accessed 27 Aug 2019. www.clevelandclinicmeded.com\/medicalpubs\/diseasemanagement\/hepatology\/gallbladder-biliary-tract-disease\/#bib1","DOI":"10.1016\/B978-1-4160-6643-9.00074-6"},{"key":"bibr3-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900729"},{"key":"bibr4-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5320-0"},{"key":"bibr5-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-9883-2"},{"key":"bibr6-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-009-0809-4"},{"key":"bibr7-0003134820942139","doi-asserted-by":"publisher","DOI":"10.3310\/hta8100"},{"key":"bibr8-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1007\/s13244-011-0129-9"},{"key":"bibr9-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810606"},{"key":"bibr10-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.3.316"},{"key":"bibr11-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/51075444"},{"key":"bibr12-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01279.x"},{"key":"bibr13-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(98)70121-X"},{"key":"bibr14-0003134820942139","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200001000-00012"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820942139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0003134820942139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820942139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:33:40Z","timestamp":1777379620000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0003134820942139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1177\/0003134820942139"],"URL":"https:\/\/doi.org\/10.1177\/0003134820942139","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]}}}