Investigation of the effect of magnetic resonance cholangiopancreatography (MRCP) findings on the prognosis of the patients we followed up with the diagnosis of acute biliary pancreatitis.

SUMMARY: Acute pancreatitis is an acute inflammatory disease of the pancreas that has a very high mortality and morbidity among gastrointestinal system diseases, and the severity and prognosis of the disease varies considerably according to the patients. Many factors are involved in the etiology of acute pancreatitis, and gallstones are the most common cause in general. Classification and scoring systems such as Ranson score and Revised Atlanta Criteria are used to determine the severity and prognosis of the disease. In radiological imaging, techniques such as USG, CT, MRI, EUS give us valuable information. In this study, we aimed to evaluate the relationship between MRCP findings and prognosis in patients followed up in the gastroenterology service of Adıyaman Training and Research Hospital with the diagnosis of acute biliary pancreatitis, and in addition, we evaluated the relationship between age, gender, length of hospital stay, and CT findings with prognostic indicators. In our study, clinical data (such as age, gender, length of hospitalization, admission symptom, mortality status, need for intensive care, Ranson score, Revised Atlanta Criterion Severity) and radiological data of 131 patients we followed up in the gastroenterology service of Adıyaman Training and Research Hospital with the diagnosis of acute biliary pancreatitis. (Pancreatic edema on CT, peripancreatic edema on CT, presence of extrapancreatic complications on CT, necrosis on CT, pancreatic edema on MRCP, choledoch diameter calculated according to age in MRCP, presence of stones in the common bile duct on MRCP, The relationship between pancreatic duct diameter, Balthazar score, Computed tomography severity index-CTSI) was analyzed retrospectively. In our study, the age and gender characteristics of our patients with biliary pancreatitis were found to be compatible with the literature. In addition, the most common presenting symptom in our patients was abdominal pain, which is consistent with the literature. Statistically significant relationships between the length of stay of our patients and the Revised Atlanta Criterion Severity, Ranson score, Balthazar Score, Computed Tomography Severity Index (CTSI), pancreatic edema on CT, necrosis on CT, extrapancreatic complications on CT and pancreatic edema on MRCP detected. However, no statistically significant relationship was found between the length of stay of our patients and their gender, age, peripancreatic edema on CT, common bile duct diameter calculated according to age in MRCP, presence of stones in the common bile duct in MRCP, and pancreatic duct diameter in MRCP. Ranson score is one of the many scoring systems that show the severity and prognosis of the disease. Statistically significant correlations were found between our patients' Ranson score and age, length of stay, Balthazar score, and Computed Tomography Severity Index (CTSI). However, the Ranson score and gender of our patients, Revised Atlanta Criterion Severity, pancreatic edema in CT, extrapancreatic edema in CT, extrapancreatic complication in CT, common bile duct diameter calculated according to age in MRCP, presence of stones in the common bile duct in MRCP, pancreatic edema in MRCP There was no statistically significant relationship between duct diameter and pancreatic edema in MRCP. The relationship between Ranson score and the presence of necrosis on CT could not be evaluated because the number of patients was insufficient for statistical evaluation. The Revised Atlanta Criterion Severity is a classification system that helps determine the severity of pancreatitis and predict its prognosis. This classification system divides pancreatitis into 3 groups as mild, moderate and severe, taking into account the radiological findings (complications) and the development of organ failure. In our study, statistically significant correlations were found between the severity of the Revised Atlanta Criterion and length of stay, pancreatic edema in CT, peripancreatic edema in CT, and pancreatic edema in MRCP. However, with the Revised Atlanta Criterion Severity, gender, age, Ranson score, Balthazar score, Computed Tomography Severity Index (CTSI), necrosis in CT, presence of extrapancreatic complications in CT, choledochal diameter calculated according to age in MRCP, stone in the common bile duct in MRCP presence, no statistically significant relationship was found with pancreatic duct diameter in MRCP. In our study, the relationship between CT and MRCP in terms of the evaluation of pancreatic edema was evaluated and it was seen that CT and MRCP were significantly related in the evaluation of pancreatic edema. However, other studies have shown that MRI is superior to CT in detecting pancreatic edema, in this respect, our study differs from the literature. Key words: Acute pancreatitis, prognosis, magnetic resonance cholangiopancreatography