Translations:Choledocholithiasis/9/en

RUQ ultrasound showing non-obstructing common bile duct stone.

• 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