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Background: Gallstone pancreatitis is a consequence of ampullary obstruction by common bile duct (CBD) calculi. Magnetic resonance cholangiopancreatography (MRCP) has been advocated for routine use to diagnose choledocholithiasis. However, the selective use of MRCP in clinically equivocal situations has not been explored until now. This study examines the diagnostic value of selective MRCP in gallstone pancreatitis. Methods: We conducted a retrospective audit of all presentations of gallstone pancreatitis between January 2001 and December 2007 at Middlemore Hospital, Auckland, New Zealand. Demographic data, clinical presentation, biochemical and radiological findings and outcomes were reviewed. Results: There were 339 cases of gallstone pancreatitis during the study period; 236 patients were women and the mean age was 52 years. Overall, choledocholithiasis was diagnosed in 95 patients. A total of 117 patients underwent MRCP within a median of 4 days of admission, with 15 (13.7%) showing choledocholithiasis. There was no significant difference in time to MRCP between positive and negative groups. Endoscopic retrograde cholangiopancreatography (ERCP)/intraoperative cholangiography (IOC) confirmed 13 of 15 stones within a median of 2.5 days. However, MRCP missed 8 cases of choledocholithiasis subsequently demonstrated on ERCP/IOC, where clinical suspicion remained after a negative MRCP. Its sensitivity was 62% and specificity 98%. The positive likelihood ratio was 6.5 and the negative likelihood ratio was 0.1. In all, 222 patients followed different clinical pathways with 82 CBD stones diagnosed by ERCP/IOC. Conclusion: Selective MRCP is highly specific in gallstone pancreatitis but may not be sensitive enough to exclude choledocholithiasis in this context. Contexte: La pancreatite biliaire est une consequence de l'obstruction de l'ampoule par des calculs du canal choledoque. On a preconise le recours a la cholangiopancreatographie par resonance magnetique (CPRM) comme mesure standard pour diagnostiquer la choledocholelithiase. Toutefois, l'emploi selectif de la CPRM dans des situations cliniquement equivoques n'a fait l'objet d'aucune etude jusqu'a present. La presente etude se penche sur l'utilite diagnostique de la CPRM selective dans la pancreatite biliaire. Methodes: Nous avons effectue un examen retrospectif de tous les cas de pancreatite biliaire repertories entre janvier 2001 et decembre 2007 au Middlemore Hospital d'Auckland, en Nouvelle-Zelande. Nous avons passe en revue les donnees demographiques, les tableaux cliniques, les resultats d'analyses biochimiques et d'epreuves radiologiques, de meme que l'issue chez les patients. Resultats: Nous avons denombre 339 cas de pancreatite biliaire au cours de la periode de l'etude; 236 touchaient des femmes et l'age moyen etait de 52 ans. Globalement, la choledocholelithiase etait le diagnostic chez 95 patients. En tout, 117 patients ont subi une CPRM apres une periode mediane de 4 jours suivant leur admission, 15 d'entre eux (13,7%) presentant des signes de choledocholelithiase. On n'a note aucune difference significative quant a l'intervalle avant la CPRM entre les groupes positifs et negatifs. La cholangiopancreatographie endoscopique retrograde (CPER)/cholangiographie peroperatoire (CPO) ont confirme 13 calculs sur 15 au cours d'une periode mediane de 2,5 jours. Toutefois, la CPRM n'a pas reussi a mettre au jour 8 cas de choledocholelithiase ulterieurement reveles par la CPER/CPO qui continuaient d'eveiller des soupcons cliniques apres une CPRM negative. Sa sensibilite a ete evaluee a 62% et sa specificite a 98%. Le rapport positif probable etait de 6,5 et le rapport negatif probable de 0,1. En tout, 222 patients ont fait l'objet de demarches cliniques differentes et 82 cas de calculs du choledoque ont ete diagnostiques au moyen de la CPER/CPO. Conclusion: La CPRM selective est fortement specifique dans les cas de pancreatite biliaire, mais pourrait ne pas etre suffisamment sensible pour exclure la choledocholelithiase dans ce contexte., Gallstone pancreatitis is a consequence of ampullary obstruction by common bile duct (CBD) calculi. (1) Successful management of gallstone pancreatitis therefore requires accurate diagnosis and, occasionally, removal of CBD stones. [...]

Aim: In New Zealand, colorectal cancer (CRC) is the second highest cause of cancer death. We sought to characterise a unique population, the individuals who attempt to engage one or multiple times with screening yet fail to ever obtain successful screening., Methods: This is a cross-sectional descriptive analysis on data from the New Zealand National Bowel Screening Programme 2012 to 2022., Results: Over 7,000 individuals (1.26% of all participants) have attempted but failed to be successfully screened in the national bowel screening programme. Males compared with females (OR 1.11, 95% CI 1.06-1.17), Asian (OR 1.65, 95% CI 1.55-1.77), Māori (OR 2.07, 95% CI 1.92-2.24) or Pacific peoples (OR 2.30, 95% CI 2.09-2.52) compared with Europeans had greater odds to attempt but fail to be screened. Māori New Zealand Index of Deprivation (NZDep) quintile five (most deprived) had 4.12 (95% CI 3.64-4.67, plt;0.0001) the odds to attempt but fail to be screened compared with European deprivation quintile one participants (least deprived)., Conclusions: There are important variations in the failure to successfully receive CRC screening by gender, age, ethnicity, deprivation level and screening year. We suggest drop-off location checking services for all participants are required., Competing Interests: CD: received no payments but research is part of contract in employment by Eastern Institute of Technolog. EIT also provided ethical approval. BM: received locality approval from Te Whatu Ora Te Matau a Māui, Hawke’s Bay and has a service contract with the National Bowel Screening Programme., (© PMA.)