Investigation of choice in suspected gall bladder stone is

(Ultrasound) (152-Sutton 17th)* ULTRASOUND - widely used as the preliminary examination in suspected gall bladder or biliary tract disease and has added advantages that liver and pancreas can be assessed at the same examination* It is highly accurate in the diagnosis of gall stones including the non opaque stones not visible at simple radiographyLaparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone (634-CMDT-10)99Tcm HIDA- isotope scanning is also a most valuable screening test for acute cholecystitisPercutaneous transhepatic cholangiography (PTC) - main indication for PTC is in the assessment of obstructive jaundice,Endoscopic retrograde cholangiopancreatography (ERCP) probably method of choice for the investigation of obstructive jaundice* Most common complication after ERCP is - Acute Pancreatitis** Stone which is resistant to Lithotripsy - cystine stone*** Focal and diffuse thickening of gall bladder with high amplitude reflection and "Comet tail" artifacts on USG- suggests - Adenomyomatosis of GBMagnetic resonance cholangiopancreatograpy (MRCP) is a radiological technique that produces images of the pancreatobiliary tree that are similar in appearance to those obtained by invasive radiographic methods such as ERCPAdvantages over ERCP* MRCP do not require administration of contrast agents or ionizing radiation* Images can be acquired faster* It is less operator dependent* Carries no risk of pancreatitis*Pancreatic divisum is the most common congenital variant of human pancreas