From the Research
Patients do not necessarily need to be Nil Per Os (NPO) for a Magnetic Resonance Cholangiopancreatography (MRCP), as the procedure does not require sedation and is non-invasive. However, to optimize image quality, it is generally recommended to avoid eating solid foods for 4-6 hours and clear liquids for 2-4 hours before the exam, as this can help reduce motion artifacts from digestive activity and allow better visualization of the biliary and pancreatic ducts 1. The specific fasting requirements may vary depending on the facility and the individual patient's needs, so it's essential to follow the instructions provided by the imaging center performing the MRCP. Some studies suggest that MRCP can be performed without fasting, especially in emergency situations, and that the use of MRCP can actually increase the efficiency of emergency hepatopancreaticobiliary surgery services 2. In general, the decision to require fasting before MRCP should be made on a case-by-case basis, taking into account the patient's medical history, the reason for the exam, and the potential risks and benefits of fasting. It's also worth noting that MRCP is a non-invasive procedure that does not require sedation, and therefore, the risks associated with fasting are generally lower compared to other procedures that require sedation, such as ERCP 3. Overall, while fasting may not be strictly necessary for MRCP, it is still important to follow the instructions provided by the imaging center and to discuss any concerns or questions with a healthcare provider. In terms of the evidence, the most recent and highest quality study on this topic is from 2023, which highlights the importance of optimizing the acquisition technique and being aware of patient-related factors and physiologic changes that can affect the performance and interpretation of MRCP 1. This study provides a general overview of the different pitfalls encountered in MRCP and offers pearls on how to manage them in real-world practice, but it does not specifically address the issue of fasting before the procedure. Therefore, the recommendation to avoid eating solid foods for 4-6 hours and clear liquids for 2-4 hours before the exam is based on general guidelines and may need to be adjusted on a case-by-case basis.