Diagnostic imaging before and after dissolution of gallbladder stones

Ultrasonography is currently the most sensitive non-invasive imaging modality for the diagnosis of gallbladder stones. It has low sensitivity, however, for the detection of fine residue, stone debris, or mucosal ulcers after percutaneous chemical contact dissolution of gallstones. Percutaneous endoscopy is much more sensitive and specific for this purpose. Computed tomography of the gallbladder and gallstones, when properly used, can help in identifying patients suitable for percutaneous contact dissolution of gallstones using cholesterol solvent such as methyl tert-butyl ether. Attention to details and appropriate analysis of the data obtained will overcome many of the shortcomings in the majority of studies that failed to appropriately correlate CT findings with gallstone dissolvability.