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The gallbladder: what’s new in 2022?

  • Special Section: Benign Biliary Disease
  • Published:
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A Correction to this article was published on 30 April 2022

This article has been updated

Abstract

This review focuses mainly on the imaging diagnosis, treatment, and complications of acute cholecystitis which is the most common benign disease of the gallbladder. The American College of Radiology appropriateness criteria for the imaging evaluation of patients with right upper quadrant pain and the Tokyo Guidelines for evaluating patients with acute cholecystitis and acute cholangitis are presented. The recent articles for using US, CT, MR, and HIDA in the evaluation of patients with suspected acute cholecystitis are reviewed in detail. The clinical management and postoperative complications are described. Because gallbladder polyps and adenomyomatosis can mimic gallbladder malignancies and acute cholecystitis, their imaging findings and management are presented. Finally, due the recent literature reporting better results with CT than US in the diagnosis of acute cholecystitis, a suggested approach for imaging patients with right upper quadrant pain and possible acute cholecystitis is presented in an addendum.

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References

  1. Shakespear JS, Shaaban AM, Rezvani M. CT Findings of Acute Cholecystitis and Its Complications. American Journal of Radiology 2010; 194:1523-1529.https://doi.org/10.2214/AJR.09.3640.

    Article  Google Scholar 

  2. Smith EA et al. Cross-Sectional Imaging of Acute and Chronic Gallbladder Inflammatory Disease. AJR 2009 192:1, 188–196. PMIP 23541278.

  3. Bennet GL(2021) Cholelithiasis, Cholecystitis, Choledocholithasis and the Hyperplastic Cholecystotses. In : Gore R and Levine M (eds) Textbook of Gastrointestinal Radiology, 5th Edition, Elsevier, Philadelphia, PA pp 689-706.

    Google Scholar 

  4. Marincek B. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies. Eur Radiol. 2002 Sep;12(9):2136-50. https://doi.org/10.1007/s00330-002-1569-x. Epub 2002 Jul 19. PMID: 12195463.

    Article  CAS  Google Scholar 

  5. Maddu K, Phadke S, Hoff C. Complications of cholecystitis :a comprehensive contemporary imaging review. Amer Soc of Emergency Radiology 2021. https://doi.org/10.1007/s10140-021-01944-z.

    Article  Google Scholar 

  6. Hiaatt KD, Ou JJ, Childs DD. Role of Ultrasound and CT in the Workup of Right Upper Qadrant Pain in Adults in the Emergency Department: A Retrospective Review of More Than 200 Cases. American Journal of Radiology 2020;214:1305-1310. https://doi.org/10.2214/AJR.1922188.

    Article  Google Scholar 

  7. Foshi G, Crawford KA, Hanna TN, Herr KD, Dahiya N, Menia CO. Us of Right Upper Quadrant Pain in the Emergency Department: Diagnosing beyond Gallbladder and Biliary Disease. RadioGraphics 2018;38:766-793 https://doi.org/10.1148/rg.2018170149.

    Article  Google Scholar 

  8. Wertz JR, Lopez JM, Olson D, Thompson WM. Comparing the Diagnostic Accuracy of Ultrasound and CT in Evaluating Acute Cholecystitis. American Journal of Radiology 2018;211:W92-W97. https://doi.org/10.2214/AJR.17.18884.

    Article  Google Scholar 

  9. Kaura S, Haghighi M, Matza B, Hajdu C, Rosenkrantz A. Comparison of CT and MRI findings in the differentiation of acute from chronic cholecystitis. Clin. Imaging. July-Aug 2013: 37 (4):687–691. https://doi.org/10.1016/jclinimg.2013.20.009.

  10. Ralls PW, Colletti PM, Lapin SA, et al. Real-time sonography in suspected acute cholecystitis:prospective evaluation of primary and secondary signs. Radiology 1985 Jun;155(3):767-71. https://doi.org/10.1148/radiology.155.3.3890007. PMID: 3890007.

    Article  CAS  Google Scholar 

  11. Perez MG, Tse JR, Bird KN, et al. Cystic artery velocity as a predictor of acute cholecystitis. Abdominal Radiology 2021 https://doi.org/10.1007/s00261-021-03020-z.

    Article  Google Scholar 

  12. Lee D, Appel S, Nunes L. CT findings and outcomes of acute cholecystitis:is additional ultrasound necessary? Abdominal Radiology 2021. https://doi.org/10.1007/s00261-021-03160-2.

    Article  Google Scholar 

  13. An C, Park S, Ko S, et al. Usefulness of the Tensile Gallbladder Fundus Sign in the Diagnosis of Early Acute Cholecystitis. American Journal of Radiology 2013;201:340-346. https://doi.org/10.2214/AJR.12.9919.

    Article  Google Scholar 

  14. Shaish H, Ma HY, Ahmed FS. The utility of an under-distended gallbladder on ultrasound in ruling out acute cholecystitis. Abdominal Radiology (2021)46:2498-2504. https://doi.org/10.1007/s00261-020-02902-y.

    Article  Google Scholar 

  15. Jarmish GM, Smith MP, Rosen MP, et al. ACR Appropriateness criteria Right Upper Quadrant Pain. J Am Coll Radiol. 2014 March;11(3):316-322. https://doi.org/10.1016/j.jacr.2013.11.017.

    Article  Google Scholar 

  16. Kiewiet JS, Keeuwenburgh MM, Bipat S, et al. A systematic Review and Meta-Analysis of Diagnostic Performance of Imaging in Acute Cholecystitis. Radiology 2012:Vol 264(3):708-20. https://doi.org/10.1148/radiol.12111561. Epub 2012 Jul 12. PMID: 22798223.

    Article  Google Scholar 

  17. Huda F, LeBedis CA, Qureshi MM, et al. Acute cholecysstitis:diagnostic value of dual-energy CT-derived iodine map and low-keV virtual monoenergetic images. Abdom Radiol. 2021. 46 (11) , 5125-5033. https://doi.org/10.1007/s00261-021-03202-9.PMID: 33223953.

    Article  Google Scholar 

  18. Kalb B, Sharma P, Salman K, Ogan K, Pattaras JG, Martin DR. Acute abdominal pain: is there a potential role for MRI in the setting of the emergency department in a patient with renal calculi? J Magn Reson Imaging. 2010 Nov;32(5):1012-23. https://doi.org/10.1002/jmri.22337. PMID: 21031504.

    Article  Google Scholar 

  19. Tonolini M, Ravelli A, Villa C, Bianco R. Urgent MRI with MR cholangiopancreatography (MRCP) of acute cholecystitis and related complications: diagnostic role and spectrum of imaging findings. Emerg Radiol. 2012 Aug;19(4):341-8. https://doi.org/10.1007/s10140-012-1038-z. Epub 2012 Mar 25. PMID: 22447440.

    Article  Google Scholar 

  20. Watanabe Y, Nagayama M, Okumura A, Amoh Y, Katsube T, Suga T, Koyama S, Nakatani K, Dodo Y. MR imaging of acute biliary disorders. Radiographics. 2007 Mar-Apr;27(2):477–95. https://doi.org/10.1148/rg.272055148. PMID: 17374864.

  21. Kim KW, Park MS, Yu JS, et al. Acute cholecystitis at T2-weighted and manganese-enhanced T1- weighted MR cholangiography: preliminary study. Radiology 2003;227:580–584.409.

  22. Park MS, Yu JS, Kim YH, et al. Acute cholecystitis: comparison of MR cholangiography and US. Radiology 1998 Dec;209(3):781-5. https://doi.org/10.1148/radiology.209.3.9844674. PMID: 9844674.

    Article  CAS  Google Scholar 

  23. Loud PA, Semelka RC, Kettritz U, et al. MRI of acute cholecystitis: comparison with the normal gallbladder and other entities. Magn Reson Imaging 1996;14:349–355. https://doi.org/10.1016/0730-725x(95)02107-5. PMID: 8782171.

    Article  CAS  Google Scholar 

  24. Weissleder R, Stark DD, Compton CC, et al. Cholecystitis: diagnosis by MR imaging. Magn Reson Imaging 1988;6:345–348. https://doi.org/10.1016/0730-725x(88)90412-2. PMID: 3398743.

    Article  CAS  Google Scholar 

  25. Hakansson K, Leander P, Ekberg O, Hakansson HO. MR imaging in clinically suspected acute cholecystitis: a comparison with ultrasonography Acta Radiol 2000;41:322–328. https://doi.org/10.1034/j.1600-0455.2000.041004322.x. PMID: 10937751.

    Article  CAS  Google Scholar 

  26. Adusumilli S, Siegelman ES. MR imaging of the gallbladder. Magn Reson Imaging Clin N Am 2002;10:165–184. https://doi.org/10.1016/s1064-9689(03)00055-2. PMID: 11998573.

    Article  Google Scholar 

  27. Akpinar E, Turkbey B, Karcaaltincaba M, Balli O, Akkapulu N, Balas S, Tirnaksiz B, Akata D, Akhan O. Initial experience on utility of gadobenate dimeglumine (Gd-BOPTA) enhanced T1-weighted MR cholangiography in diagnosis of acute cholecystitis. J Magn Reson Imaging. 2009 Sep;30(3):578-85. https://doi.org/10.1002/jmri.21887. PMID: 19711404.

    Article  Google Scholar 

  28. Gupta RT. Evaluation of the biliary tree and gallbladder with hepatocellular MR contrast agents. Curr Probl Diagn Radiol 42: 67‑76, 2013. https://doi.org/10.1067/j.cpradiol.2012.08.004. PMID: 23332139.

    Article  Google Scholar 

  29. Tomizawa M, Shinozaki F, Tanaka S, Sunaoshi T, Kano D, Sugiyama E, Shite M, Haga R, Fukamizu Y, Fujita T, Kagayama S, Hasegawa R, Shirai Y, Motoyoshi Y, Sugiyama T, Yamamoto S, Ishige N. Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression/T2 image fusion for the diagnosis of acute cholecystitis. Exp Ther Med. 2017 Jul;14(1):730–734. https://doi.org/10.3892/etm.2017.4561. Epub 2017 Jun 8. PMID: 28672991; PMCID: PMC5488676.

  30. Wang A, Shanbhogue AK, Dunst D, Hajdu CH, Rosenkrantz AB. Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis. J Magn Reson Imaging. 2016 Jul;44(1):89-97. https://doi.org/10.1002/jmri.25128. Epub 2015 Dec 22. PMID: 26691912.

    Article  Google Scholar 

  31. Dillehay G, Bar-Sever Z, Brown M, Brown R, Green E, Lee M, Lim J, Metter D, Trout A, Wagner R, Wani S, Ziessman H, Kauffman J, Ahuja S, Donohoe K. Appropriate use criteria for hepatobiliary scintigraphy in abdominal pain: : Summary and Excerpts. J Nucl Med. 2017 Jun;58(6):9N-11N. PMID: 28572300.

    Google Scholar 

  32. Tulchinsky M, Ciak BW, Delbeke D, Hilson A, Holes-Lewis KA, Stabin MG, Zeissman HA. SNM practice guideline for hepatobiliary scintigraphy 4.0. J Nucl Med Technol. 2010;38:210–218.

  33. Flancbaum L, Choban P. Use of morphine cholescintigraphy in the diagnosis of acute cholecystitis in critically ill patients. Intensive Care Med. 1995;21: 120–124.

    Article  CAS  Google Scholar 

  34. Mariat G, Mahul P, Prévôt N, et al. Contribution of ultrasonography and cholescintigraphy to the diagnosis of acute acalculous cholecystitis in intensive care unit patients. Intensive Care Med. 2000;26:1658–1663.

    Article  CAS  Google Scholar 

  35. Mirvis SE, Vainright JR, Nelson AW, et al. The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT. AJR Am J Roentgenol. 1986;147:1171–1175.

    Article  CAS  Google Scholar 

  36. Prévôt N, Mariat G, Mahul P, et al. Contribution of cholescintigraphy to the early diagnosis of acute acalculous cholecystitis in intensive-care-unit patients. Eur J Nucl Med. 1999;26:1317–1325.

    Article  Google Scholar 

  37. Weissman HS, Berkowitz D, Fox MS, et al. The role of technetium-99m iminodiacetic acid (IDA) cholescintigraphy in acute acalculous cholecystitis. Radiology 1983;1 46: 1 77–1 80.

  38. Shuman WP, Rogers JV, Audd TG, Mack LA, Plumley T, Larson EB. Low sensitivity of sonography and cholescintigraphy in acalculous cholecystitis. AJR 1984;1 32:531-534.

    Article  Google Scholar 

  39. Peters JH, Ollila D, Nichols KE, Gibbons GD, Davanzo MA, Miller J, Front ME, Innes JT, Ellison EC. Diagnosis and management of bile leaks following laparoscopic cholecystectomy. Surg Laparosc Endosc. 1994 June;4(3):163-70. PMID: 8044356.

    CAS  Google Scholar 

  40. Trerotola SO, Savader SJ, Lund GB, Venbrux AC, Sostre S, Lillemoe KD, Cameron JL, Osterman FA Jr. Biliary tract complications following laparoscopic cholecystectomy: imaging and intervention. Radiology. 1992 Jul;184(1):195-200. https://doi.org/10.1148/radiology.184.1.1535161. PMID: 1535161.

    Article  CAS  Google Scholar 

  41. Sharma P, Kumar R, Das KJ, Singh H, Pal S, Parshad R, Bal C, Bandopadhyaya GP, Malhotra A. Detection and localization of post-operative and post-traumatic bile leak: hybrid SPECT-CT with 99mTc-Mebrofenin. Abdom Imaging. 2012 Oct;37(5):803-11. https://doi.org/10.1007/s00261-011-9840-8. PMID: 22302118.

    Article  Google Scholar 

  42. Gracie WA, Ransohoff DF. The natural history of silent gallstones: the innocent gallstone is not a myth. N Engl J Med. 1982;307:798–800.

    Article  CAS  Google Scholar 

  43. Chen PF, Nimeri A, Pham QH, Yuh JN, Gusz JR, Chung RS. The clinical diagnosis of chronic acalculous cholecystitis. Surgery. 2001;130:578–581.

    Article  CAS  Google Scholar 

  44. Shaffer E. Acalculous biliary pain: new concepts for an old entity. Dig Liver Dis. 2003;35(Suppl. 3):S20–5.

    Article  Google Scholar 

  45. Flick KF, Soufi M, Sublette CM, Sinsabaugh CA, Colgate CL, Tann M, House MG. Optimal hepatobiliary scintigraphy for gallbladder dyskinesia. Surg Open Sci. 2021 Nov 19;4:7-11. https://doi.org/10.1016/j.sopen.2020.10.003. PMID: 33569543; PMCID: PMC7847953.

    Article  Google Scholar 

  46. Ziessman HA, Tulchinsky M, Lavely C, et al. Sincalide-stimulated cholescintigraphy: a multicenter investigation to determine optimal infusion methodology and gallbladder ejection fraction normal values. J Nucl Med. 2010;51:277–281.

    Article  Google Scholar 

  47. Zeissman HA, Jones DA, Muenz LR, Agarval AK. Cholecystokinin Cholescintigraphy: Methodology and Normal Values Using a Lactose-Free Fatty-Meal Food Supplement. J Nucl Med 2003; 44:1263–1266.

    Google Scholar 

  48. Klieger PS, O’Mara RE. The clinical utility of quantitative cholescintigraphy: the significance of gallbladder dysfunction. Clin Nucl Med. 1998;23:278–282.

    Article  CAS  Google Scholar 

  49. Whitaker LF, Bosley ME, Refugia JM, Powell MS, McNatt SS, Westcott CJ, Koch KL, Bennett P, Rigdon J, Fernandez AZ. Outcomes After Laparoscopic Cholecystectomy in Hyperkinetic Biliary Dyskinesia. Am Surg. 2021 May 28:31348211023390. https://doi.org/10.1177/00031348211023390. Epub ahead of 52./

  50. Eltyeb HA, Al-Leswas D, Abdalla MO, Wayman J. Systematic review and meta-analyses of cholecystectomy as a treatment of biliary hyperkinesia. Clin J Gastroenterol. 2021 Oct;14(5):1308-1317. https://doi.org/10.1007/s12328-021-01463-x. Epub 2021 Jun 11. PMID: 34115337.

    Article  Google Scholar 

  51. Williford ML, Fay KT, Simpson FJ, Defnet AM, Schuster DM, Sethi I, Lin E, Davis SS Jr. Optimal Management of the Hyperkinetic Gallbladder: A Comparison of Outcomes Between Operative and Nonoperative Approaches. Am Surg. 2021 Jun;87(6):903-909. https://doi.org/10.1177/0003134820966283. Epub 2020 Dec 7. PMID: 33284026.

    Article  Google Scholar 

  52. Pillenahalli Maheshwarappa R, Menda Y, Graham MM, Boukhar SA, Zamba GKD, Samuel I. Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study. Surgery. 2020 Nov;168(5):800–808. https://doi.org/10.1016/j.surg.2020.06.005. Epub 2020 Jul 9. PMID: 32653205.

  53. Santucci NR, Hyman PE, Harmon CM, Schiavo JH, Hussain SZ. Biliary Dyskinesia in Children: A Systematic Review. J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):186-193. https://doi.org/10.1097/MPG.0000000000001357. PMID: 27472474.

    Article  Google Scholar 

  54. Schiappacasse G, Soffia P, Silva C, et al. Computed tomography imaging of complicatins of acute cholecystitis. Indian Journal of Radiology and Imaging/Volume 28/Issu e2 April- June 2018. https://doi.org/10.4103/ijri. IJRI 316–17.

  55. Cheng SM, Ng, SP, et al. Hyperdense Gallbladder Wall Sign An Overlooked Sign of Acute Cholecystitis on Unenhanced CT Examination. Journal of Clinical Imaging 28 (2004) 128-131. https://doi.org/10.1016/S0899-7071(03)00196-7.

    Article  Google Scholar 

  56. Chang WC, Sun Y Wu EH, et al. CT Finding for Detecting the Presence of Gangrenous Ischemia in Cholecystitis. American Journal of Radiology 2016;207:302–309.https://doi.org/10.2214/AJR.15.15658.

  57. Bennett, GL, Rusinek H, et al. CT Findings in Acute Gangrenous Cholecystitis. American Journal of Radiology 2002; 178(2):275-81. https://doi.org/10.2214/ajr.178.2.1780275. PMID: 11804880.

    Article  Google Scholar 

  58. Sagar P, Singh AK. Gangrenous Cholecystitis: prediction with CT Imaging. Abdominal Imaging 30, 218-221 (2005). https://doi.org/10.1007/s00261-004-0217-0.

    Article  Google Scholar 

  59. Wu, CH, Chen CC, et al. Discrimination of Gangrenous from Uncomplicated Acute Cholecystitis: Accuracy of CT Findings. Abdominal Imaging(2011) 36:174-178. https://doi.org/10.1007/s00261-010-9612-x.

    Article  Google Scholar 

  60. Teefey SA, Dahiya N, et al. Acute Cholecystitis: Do Sonographic Findings and WBC Count Predict Gangrenous Changes? American Journal of Radiology2013; 200:363-369. https://doi.org/10.2214/AJR.12.8956.

    Article  Google Scholar 

  61. Revel L, Lubrano J, et al. Preoperative Diagnosis of Gangrenous Acute Cholecystitis: Usefulness of CEUS. Adominal Imaging (2014) 39:1175-1181. https://doi.org/10.1007/s00261-014-0151-8.

    Article  Google Scholar 

  62. Calderon JR, Chamorro EM, Sanz LI, et al. Hemorrhagic cholecystitis :ultrasound and CT imaging findings-a retrospective case review series. Emerg Radiol (2021) (3):613-620. https://doi.org/10.1007/s10140-020-01879-x. Epub 2021 Jan 19. PMID: 33464440.

    Article  Google Scholar 

  63. Wada K, Takada T, Kawarada Y, et al. Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007;14(1)P:52–58. https://doi.org/10.1007/s00534-006-1156-7.

  64. Takada T, Strasberg SM, Solomkin JS, et al.TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):1-7. https://doi.org/10.1007/s00534-012-0566-y. PMID: 23307006.

    Article  Google Scholar 

  65. Yokoe M, Hata J, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):41-54. https://doi.org/10.1002/jhbp.515.

    Article  Google Scholar 

  66. Pisano M, Allievi N, Gurusamy K, et al. 2020 World Society of Emergency Surgery updated guidelinesfor the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg. 2020;15(1):61. Published 2020 Nov 5. https://doi.org/10.1186/s13017-020-00336-x.

  67. Spirou Y, Petrou A, Christoforides C, Felekouras E. History of biliary surgery [puplished correction appears in World J Surg. 2013 Jul;37(7):1748. Yannos, Spirou [corrected to Petrou, Athanasios]; Christos, Christoforides [corrected to Felekouras, Evangelos]. World J Surg. 2013;37(5):1006–1012. https://doi.org/10.1007/s00268-013-1960-6.

  68. Strasberg SM. Clinical practice. Acute calculus cholecystitis. New England Journal of Medicine 358(26):2804. 2014 Aug 20;2014:0411. PMID: 25144428; PMCID: PMC4140413.

  69. Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ. Subtotal Cholecystectomy-“Fenestrating” vs Reconstituting” Subtypes and the Prevention of Bile Duct Injury: Definition of the Optimal Procedure in Difficult Operative Conditions. J Am Coll Surg. 2016;p222(1):89–96. https://doi.org/10.1016/j.jamcollsurg.2015.09019.

  70. Marks, B, Al Samaraee A. Laparoscopic Exploration of the Common bile Duct: A Systematic Review of the Published Evidence Over the Last 10 years. Am Surg. 2021;87(3):404-418. https://doi.org/10.1177/0003134820949527.

    Article  Google Scholar 

  71. Widmer J, Alvarez P, Sharaiha RZ, et al. Endoscopic Gallbladder Drainage for Acute Cholecystitis. Clin Endosc 2015;48:411-420. https://doi.org/10.5946/ce.2015.48.5.411.

    Article  Google Scholar 

  72. Sugawara S, Sone M, Morita S, et al. Radiologic Assessment for Endoscopic US-guided Biliary Drainage.RadioGraphics 2020;40:667-683. https://doi.org/10.1148/rg.202001901588

    Article  Google Scholar 

  73. Akhtar A, Bukhari MM, Traiq U, Sheikh AB, Siddiqui FS, Sohail MS, Khan A. 2018. Spilled gallstones silent for a decade: a case report and review of literature. Cureus. 10(7):e2921. https://doi.org/10.7759/cureus.2921. PMID: 30202664; PMCID: PMC6128371.87

    Article  Google Scholar 

  74. Kaushik R. 2010. Bleeding complications in laparoscopic cholecystectomy: incidence, mechanisms, prevention, and management. Journal of Minimal Access Surgery. 6(3):59-65. https://doi.org/10.4103/0972 9941.68579. PMID: 20877476; PMCID: PMC2938714

    Article  Google Scholar 

  75. Eisentstein S. Greenstein AJ, Kim U, Divino CM. 2008. Cystic duct stump leaks after the learning curve. Archives of Surgery 2008 Dec;143(12):1178–83. https://doi.org/10.1001/archsurg.143.12.1178. PMID: 19075169.

  76. Renz BW, Bosch F, Martin KA. 2017. Bile duct injury after cholecystectomy: surgical therapy. Visceral Medicine. 33(3):184- 190. https://doi.org/10.1159/000471818. Epub 2017 May 26. PMID: 28785565; PMCID: PMC5527188. .

  77. Kim KH. Gallbladder polyps: evolving approach to the diagnosis and management. Yeungnam Univ J Med.2021 Jan;38(1):1-9. https://doi.org/10.12701/yujm.2020.00213. Epub 2020 May 15.

    Article  Google Scholar 

  78. Sebastian s et al. Managing incidental findings on abdominal and pelvic CT and MRI, part 4 white paper of the ACR incidental findings committee II on gallbladder and biliary findings. J Am Coll Radiol 2013;10(12):953–956.

  79. Wiles, R, Thoeni RF, et al. Management and follow-up of gallbladder polyps. Eur Radiol (2017) 27:3856-3866. DOI https://doi.org/10.1007/s00330-017-4742-y.

    Article  Google Scholar 

  80. Hammad A, et al A literature review of radiological findings to guide the diagnosis of gallbladder adenomatosis. Journal of the International Hepato Pancreas Biliary Association (Oxford). 2016 Feb; 18(2):129-135. https://doi.org/10.1016/j.hpb.2015.09.006.Epub 2016 Jan 6.

    Article  Google Scholar 

  81. Jung SE, Lee JM, Leek, Rha SE, et al. Gaallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol 2005 Apr;15(4):694–701. https://doi.org/10.1007/s00330-004-2539-2. Epub 2004 Nov 24. PMID:15565318

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Acknowledgements

The authors would like give a special thanks to Dr Koenraad Mortele of Boston, MA for his editorial assistance.

Author information

Authors and Affiliations

  1. Department of Radiology, University of New Mexico, MSC10 5530, 1 University of New Mexico, Albuquerque, NM, 87131, USA

    Rachel Runde, Shana Elman & William M. Thompson

  2. Department of Surgery, University of New Mexico, Albuquerque, NM, USA

    Edward D. Auyang, Raye Ng & Kaysey Llorente

  3. Department of Radiology, University of Arizona, Tucson, AZ, USA

    Hina Arif Tiwari

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  1. Rachel Runde
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Addendum

Addendum

Attachment: Proposed New Algorithms Based Upon Recent Literature vs ACR

  1. (1)

    Clinical- Probable AC-US + with stones w/o Bile Duct dilatation (BDD)-Treatment.

  2. (2)

    Clinical- RUQ Pain not necessarily AC-CT if positive with stones and no BDD-Treatment.

  3. (3)

    Clinical- RUQ Pain Positive US for AC + Stones without BDD-Treatment.

  4. (4)

    Clinical- RUQ Pain CT + with stones but without BDD-Treatment.

  5. (5)

    Clinical- RUQ Pain CT + without stones and BDD-US-Treatment.

  6. (6)

    Clinical- RUQ Pain US and CT negative for AC but high clinical suspicion for AC -HIDA or MRCP especially if Bile Ducts enlarged, if stones-ERCP/Treatment.

  7. (7)

    Clinical- RUQ Pain US and CT + but Bile Ducts enlarged without CBD stones-MRCP-If stones ERCP then Treatment

  8. (8)

    Clinical- RUQ Pain US and CT + but Bile Ducts enlarged with CBD stones- ERCP removal then Treatment.

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Runde, R., Auyang, E.D., Ng, R. et al. The gallbladder: what’s new in 2022?. Abdom Radiol 48, 2–28 (2023). https://doi.org/10.1007/s00261-022-03429-0

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  • DOI: https://doi.org/10.1007/s00261-022-03429-0

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