Clinical Diagnosis Of Obstruction Of Lower Biliary Tract

Objective To suggest best clinical diagnosis method by evaluating all diagnostic data of obstruction of lower biliary tract. Methods The clinical data of 56 cases which had clearly diagnosised obstruction of lower biliary tract in our hospital were retrospectively analysised from Jan, 2000 to Nov,2002. Results General condition and clinical test data of 56 cases have no specially difference. There were 41.07% of choledocholith in 56 cases. The diagnostic accuracy of US in the choledocholith was 82.60%, MRCP was 91.30%. It is no significant difference between US and MRCP in statistics. There is 42.86% of malignant obstruction in 56 cases. The diagnostic accuracy of US was 33. 37%, MRCP was95. 83%. They have significant difference in statistics. In all cases, the location accuracy of US was 76.8% and MRCP was 100%. The qualitative accuracy of US was 60.7% and MRCP was 94. 67%.But the location accuracy or the qualitative accuracy has no significant difference in benign obstructive disease between US and MRCP in statistics. They have significant different in malignant obstruction disease. Meanwhile, MRCP can clearly display form alteration such as dimension , size of different lower biliary lesion. It can locate position of lesion, indicate relation of circumference tissue, found metastasis in malignant obstruction disease. Conclusion There is no different indiagnostician benign obstructive disease such as choledoch-olith between US and MRCP. MRCP is first choices. MRCP is best method to diagnosis malignant biliary obstructive disease. It has extraordinary diagnostic value. It should perform as routine examination when patient is suspected malignant obstruction. Specially, when we are ready for performing traumatic examination or making in specific operative program, should firstly choice MRCP.