[Diseases and diagnosis of the biliary system : When does the gastroenterologist need the radiologist?]

Biliary diseases require fast and rational use of diagnostic tests by both gastroenterologists and radiologists.

Standard diagnostic workup includes transabdominal ultrasound, endoscopic retrograde cholangiography (ERC), endoscopic ultrasound, direct cholangioscopy, magnetic resonance cholangiopancreatography (MRI/MRCP), and computed tomography (CT).

Modular cholangioscopy is a novel diagnostic method.

The goal of diagnostic examinations is the determination of the location of obstructions and differentiation of benign from malignant lesions.

Transabdominal ultrasound is risk-free and can show the gallbladder in great detail providing high diagnostic accuracy in most conditions. Endoscopic ultrasound, ERC and/or cholangioscopy are powerful tools to investigate the large bile ducts but are associated with inherent procedural risks.

Gall bladder diseases can often be diagnosed with transabdominal ultrasound alone. Bile duct disease often requires the use of endoscopic ultrasound, ERC and/or cholangioscopy.