DIAGNOSTIC PROTOCOLS FOR CHOLELITHIASIS: THE ROLE OF ABDOMINAL ULTRASOUND AS THE GOLD STANDARD

Abstract

Cholelithiasis is one of the most prevalent gastrointestinal diseases worldwide, affecting a significant portion of the adult population and representing an important cause of morbidity when associated with complications such as acute cholecystitis, cholangitis, and biliary pancreatitis. Although a large proportion of cases remain asymptomatic, progression to symptomatic conditions requires accurate and timely diagnosis for appropriate therapeutic definition. In this context, abdominal ultrasound has become established as a first-line method in the investigation of biliary lithiasis, presenting high sensitivity and specificity for gallstones, in addition to advantages such as low cost, wide availability, and absence of ionizing radiation. However, its limitation in detecting choledocholithiasis, especially in the absence of biliary tract dilation, reinforces the need for integration with clinical and laboratory parameters, as well as with more accurate imaging methods, such as magnetic resonance cholangiopancreatography and endoscopic ultrasound. Therefore, the diagnostic approach to cholelithiasis should be based on a systematized and individualized protocol, allowing for adequate risk stratification, prevention of complications, and optimization of clinical outcomes.