LFTs, lipase, and basic chemistry
Imaging
RUQ Ultrasound
Noninvasive and quick
Common bile duct < 6 mm plus 1mm per decade after 60 yrs old
US is highly sensitive and specific for acute cholecystitis, much less sensitive/specific in identifying cholelithiasis due to exam limitations (i.e. difficulty identifying the CBD)
ERCP - highly sensitive and specific, also therapeutic
MRCP - comparable sensitivity/specificity to ERCP
HIDA Scan - not useful, as IDA (technetium 99m-labeled iminodiacetic acid) can still go into gallbladder
RUQ Ultrasound
Noninvasive and quick
Common bile duct < 6 mm plus 1mm per decade after 60 yrs old
US is highly sensitive and specific for acute cholecystitis, much less sensitive/specific in identifying cholelithiasis due to exam limitations (i.e. difficulty identifying the CBD)
ERCP - highly sensitive and specific, also therapeutic
MRCP - comparable sensitivity/specificity to ERCP
HIDA Scan - not useful, as IDA (technetium 99m-labeled iminodiacetic acid) can still go into gallbladder
Noninvasive and quick
Common bile duct < 6 mm plus 1mm per decade after 60 yrs old
US is highly sensitive and specific for acute cholecystitis, much less sensitive/specific in identifying cholelithiasis due to exam limitations (i.e. difficulty identifying the CBD)
Choledocholithiasis
Gallbladder disease
Ascending cholangitis
Acute cholecystitis
Acalculous cholecystitis
Cholangitis
Acute calculous cholecystitis
Symptomatic cholelithiasis/Biliary Colic