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The Use of Imaging in Gallbladder Disease

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Book cover Acute Cholecystitis

Abstract

Diseases of the gallbladder and biliary tree are conditions that physicians routinely encounter, and they can present multiple diagnostic and treatment dilemmas. Cholelithiasis, choledocholithiasis, and acute cholecystitis are only some of the many potential diagnoses. Recent advances in imaging modalities have provided numerous options to aid clinicians in confirming or clarifying a particular diagnosis. For most cases of acute cholecystitis, ultrasound remains the initial diagnostic imaging of choice. It is inexpensive, readily available, and easily repeatable. HIDA scans also can be helpful, especially if an initial ultrasound is equivocal. These scans also have a role in the post-operative setting to evaluate for biliary leaks. MRI and MRCP provide high-resolution images of the hepatobiliary system with excellent tissue contrast. Currently, this modality is especially useful in the evaluation choledocholithiasis, and it will likely play an increasing role in the diagnosis of acute cholecystitis as MRI technology improves and becomes more widely available. CT scans are available to most patients, but have the downside of delivering ionizing radiation. They are most useful when the clinical picture is unclear or when there are additional symptoms outside of the right upper quadrant. By tailoring the selection of radiographic images to the individual patient scenario, clinicians can maximize diagnostic utility and mitigate unnecessary costs and radiation exposure.

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  1. Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 195, Minneapolis, MN, 55455, USA

    Christopher J. LaRocca M.D., Torfi Hoskuldsson M.D. & Greg J. Beilman M.D.

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  1. Christopher J. LaRocca M.D.
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Correspondence to Greg J. Beilman M.D. .

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  1. Department of Surgery, Weill Cornell Medical College, New York, New York, USA

    Soumitra R. Eachempati

  2. Department of Surgery, Indiana University Acute Care Surgery, Indiana University Health Methodist Hospital, Indianapolis, Indiana, USA

    R. Lawrence Reed, II

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LaRocca, C.J., Hoskuldsson, T., Beilman, G.J. (2015). The Use of Imaging in Gallbladder Disease. In: Eachempati, S., Reed, II, R. (eds) Acute Cholecystitis. Springer, Cham. https://doi.org/10.1007/978-3-319-14824-3_4

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