الفهرس 
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Abstract
Obstructive Jaundice is highly prevalent in Egypt, resulting in high morbidity with increasing cost-burden. Numerous investigations are proposed for diagnosis of obstructive jaundice, ERCP and MRCP, with high sensitivity and specificty among other investigations for diagnosis the cause of obstructive jaundice. However, ERCP is considered invasive method that must be preserved as a lifeboat for therapy.
We aim toevaluates a cohort of patients at high risk for obstructive juandice who all required ERCP to determine frequency of MRCP use and the factors and outcomes associated with MRCP prior to ERCP.
We admitted 60 patients distributed into two groups: First group: patients underwent MRCP (30 patients): MRCP was done for all patients and then ERCP will be done according of MRCP finding if positive or negative for CBD stones or suspected malignancy, Second group: patients underwent ERCP directly. (30 patients)
MRCP was conducted at MRI unit in radiology department, and ERCP was done at surgery department at Menoufia University Hospital, MRI scanner used was, 1.5-T scanner (Magneton Avanto, Siemens, Erlangen, Germany) using an in-house using 16 channel body coil.
Our results showed: in first group (MRCP ± ERCP), Scheduled ERCP was cancelled in 10 patients of 30 patients (33.3%) due to negative MRCP detection for stone or tumor.ERCP was done for 20 patients of 30 patients (66.6%) with success intervention (94.7%) either in extraction of stone (in case of small stones) or stent placement (in large stones or tumours). In second group ERCP directly was done for 30 patients. Unnecessary ERCP was done for 9 cases (30%) Success intervention for ERCP in detection of stone or malignancy was 90.4%.
Our study showed a peak increase inaccuracy, sensitivity, specificity after addition of MRCP prior to ERCP in diagnosis the cause of obstructive jaundice.
In conclusion:Our study showed that MRCP prior to ERCP is very beneficial, decrease considerably the number of unnecessary ERCP and decrease post operative complications of ERCP.