Diagnostic studies-cholelithiasis

• Labs normal in most

• RUQ U/S: Se & Sp >95% for stones >5 mm; should be performed after ≥8 h fast for distended, bile-filled gallbladder. If ⊖, repeat in 1 mo to detect missed stones

• Endoscopic U/S (EUS): Se 94–98% in Pts w/ biliary pain but nl U/S (J Hepatol 2016;65:146)

• CT scan/KUB is less Se; stones often isodense w/o enough calcium & will be missed