This is a new guideline from NICE on gallstone disease. It doesn’t say anything very surprising and doesn’t change our current management, but does try to unify practice, which can currently be quite variable.
Remember that 15% of adults have gallstones, but only some of these will go on to have symptoms from them.
Investigations
- LFT
- USS
If there are abnormal LFT or a dilated biliary tree, but no gallstones are found, refer them as they will likely need MRCP (MR cholangiopancreatography). Endoscopic USS may be needed if MRCP doesn’t give a diagnosis.