Background: Gall stones in the common bile duct are known as choledocholithiasis. It is composed of either bile pigment or calcium and cholesterol salts. The prevalence of choledocholithiasis is between 10% and 20%. The exact frequency and prevalence of choledocholithiasis are unknown. Objective: The main objective of this study is to present the comparative analysis of diagnostic accuracy of ultrasonography and Magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography for diagnosis of choledocholithiasis. Methodology: One hundred twelve cases of choledocholithiasis included were referred to the department of radiology district headquarter/teaching hospital Gujranwala during the period of 9 months. Ultrasound, MRCP and ERCP were performed. An informed consent to include their data with the assurance of confidentiality was obtained from patients. Results: In this study, during the 9-month study period, a total of one hundred twelve patients ranging in age from 18 years to 85 years old were included, with average age of 48.18 years ± 16.82 years. The studied patients were of both Genders, including 67 (59.8%) female, and male 45 (40.2%). Choledocholithiasis had been diagnosed in 28 cases (25%), 44 cases (39.3%) and 54 cases (48.2%) out of total of 112 cases on ultrasonography, MRCP, and ERCP, correspondingly. MRCP shows improved diagnostic accuracy and higher sensitivity (88.39% and 78.18%) than that of ultrasonography (72.32%, and 47.27%), correspondingly. MRCP had provided better visualization of distal CBD stone in 23.2% than that of ultrasonography 14.3%. MRCP has shown better diagnostic accuracy in identifying (31.3%) single CBD than that of ultrasonography 19.6%. Conclusion: MRCP can be replaced with invasive therapeutic procedures like ERCP and preferably used due to high diagnostic accuracy, and high sensitivity than that of ultrasonography for the diagnosis of choledocholithiasis ultrasonography is the initial choice for investigation of choledocholithiasis.
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