SİSTİK KANALIN ANA SAFRA KANALINA BİRLEŞME YERİNİN SAFRA TAŞI VE/VEYA KOLESİSTİT GELİŞİMİYLE İLİŞKİLİ OLUP OLMADIĞININ MRKP İLE SAPTANMASI

Abstract

Amaç Safra taşı ve taşın neden olduğu inflamatuar süreçlerin gelişmesi çok sayıda biyolojik faktöre bağlıdır. Hem taş gelişmesi hem de bunun inflamasyona neden olması için yatkınlık oluşturan faktörlerin bilinmesi hastalığı öngörmede, takibini yapmada ve tedavisinde ve sonraki komplikasyonların yönetiminde oldukça önemlidir. Çalışmamızın amacı, sistik kanal (SK) uzunluğunun, sistik kanalın ana hepatik kanal (AHK) ile birleşme yeri düzeyinin ve yönünün, kolesistit ve kolelitiazis ile ilişkisi olup olmadığını saptamaktır. Gereç ve Yöntem Çalışmamıza, 2017 ocak ile 2020 aralık tarihleri arasında manyetik rezonans kolanjiopankteatikografi (MRKP) çekilen 172 hasta retrospektif olarak değerlendirilmek suretiyle dahil edildi. 1.5 Tesla MR cihazı ile (Signa HDI, General Electric, Milwaukee, WI, USA), HD 8 kanallı body array coil kullanılarak çekimler yapıldı. Elde edilen bulgular SPSS Versiyon 23 programı ile analiz edildi. Bulgular SK’nın ana AHK ile birleştiği düzeyin taş ve/veya kolesistit gelişimiyle anlamlı olarak korelasyon göstermediği saptandı (p>0.05). Benzer şekilde SK’nın AHK’ya açıldığı yön ile taş ve/veya kolesistit gelişimi arasında anlamlı ilişki saptanmadı(p>0,05). SK uzunluğu 2 cm’nin altında olan 27 (%15,7) olgunun 3(%11,1)’ünde yalnızca taş, 8 (%29,6)’inde ise kolesistit saptanmış olup 16 (%59,2)’u ise normaldir. 2-4 cm arasında 88 (%51,2) olgunun 43(%48,8)’ünde yalnızca taş, 19 (%21,5)’unda ise taşlı kolesistit saptanmış olup 26 (%29,5) olgu ise normaldir. 4 cm’den daha uzun sistik kanalı olan 57 (%33,1) olgunun 31 (%54,3)’inde yalnızca taş, 16 (%28)’sında ise kolesistit saptanmış olup 10 (%17,5)’u ise normaldir. SK uzunluğu arttıkça taş ve/veya kolesistit gelişme sıklığı artmaktadır (p<0,05). Sonuç SK’nın AHK’ya açıldığı yön ve seviye taş ve/veya kolesistit gelişimine yatkınlık oluşturmazken, uzunluğundaki artış ise taş ve/veya kolesistit gelişimine yatkınlığı arttırmaktadır.

Keywords

• Kolesistit
• kolelitiazis
• MRCP
• sistik kanal

MAGNETIC RESONANCE CHOLANGIO PANCREATICOGRAPHY (MRCP) DETECTION OF WHETHER THE JUNCTION OF THE CYSTIC DUCT TO THE COMMON BILE DUCT IS ASSOCIATED WITH THE DEVELOPMENT OF GALLSTONES AND/OR CHOLECYSTITIS

Abstract

Objective The development of gallstones and stone-induced inflammatory processes depends on a number of biological factors. Knowledge of the predisposing factors for both the development of stones and their inflammation is important in predicting, monitoring, and treating the disease and managing subsequent complications. The aim of our study was to determine whether the length of the cystic duct (CD), the level and direction of the junction of the cystic duct with the common hepatic duct (CHD) are associated with cholecystitis and cholelithiasis. Material and Method This retrospective study included 172 patients who underwent MRCP between January 2017 and December 2020. A 1.5 Tesla MR device (Signa HDI, General Electric, Milwaukee, WI, USA) was used with an HD 8-channel body array coil. The findings were analyzed using SPSS version 23 software. Results The level at which the CD merged with the main CHD was not significantly correlated with the development of calculi and/or cholecystitis (p>0.05). Similarly, there was no significant correlation between the direction of the CD opening into the CHD and the development of calculi and/or cholecystitis (p>0.05).Of 27 (15.7%) cases with CD length less than 2 cm, 3(11.1%) had only stones, 8 (29.6%) had cholecystitis and 16 (59.2%) were normal. Of 88 (51.2%) cases between 2 and 4 cm, 43 (48.8%) had only calculi, 19 (21.5%) had cholecystitis with calculi and 26 (29.5%) were normal. Of 57 (33.1%) patients with cystic duct longer than 4 cm, 31 (54.3%) had only stones, 16 (28%) had cholecystitis and 10 (17.5%) were normal. As CD length increased, the frequency of stone and/or cholecystitis increased (p<0.05). Conclusion The direction and level of CD involvement in CHD does not predispose to the development of stones and/or cholecystitis, whereas an increase in its length predisposes to the development of stones and/or cholecystitis.

Keywords

• Cholecystitis
• cholelithiasis
• MRCP
• cystic duct

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