TTP4.03 MRCP use in gallstone pancreatitis audit

Introduction The use of magnetic resonance cholangiopancreatography (MRCP) scanning to identify common bile duct (CBD) stones in those presenting with gallstone pancreatitis is controversial. The guidance is not agreed for those with mild/moderate risk of CBD stones. This leads to significant differences in the management of this phenomenon. The aim of this two-cycle audit is to quantify consultant attitude toward MRCP scans for patients admitted with gallstone pancreatitis. Method During the year of 2022, all patients admitted with clinical and biochemical gallstone pancreatitis to a surgical unit were included. Data pertaining to MRCP scan use was assessed. An assessment of change to acute management as a result of this scan was made. This data was shared with all surgical consultants at a local meeting and then the same data parameters were measured over the following 6 months. Results The first cycle highlights that 87% of patients received an MRCP scan. 86% of scans showed no radiological evidence of CBD stone. 24% of patients had an acute surgical procedure. The second cycle shows that 59% of patients were offered an MRCP scan, 82% showed no CBD stone and 25% of patients received an emergency procedure. Conclusion A similar proportion of patients receive an emergency procedure upon their index admission for gallstone pancreatitis, despite a 28% drop in MRCP scan use following departmental education. The use of MRCP does not acutely change management in the majority of cases.