Ultrasound

■ Contrast-enhanced CT scan (CT angiogram is preferred)

■ Magnetic resonance cholangiopancreatography (MRCP)

■ Cholangiography [if invasive cholangiography is necessary, percutaneous cholangiography (PTC) is preferred over endoscopic retrograde cholangiopancreatography (ERCP)]

■ Direct arteriography (rarely needed)

■ Important anatomic details: porcelain gallbladder, mass, enlarged/necrotic lymph nodes, arterial involvement, portal venous involvement, adjacent organ (colon, duodenum) involvement, peritoneal metastasis

■ Gallbladder polyp [solitary, sessile, large (>1 cm) polyps are worrisome for cancer]

■ Look at anomalous pancreaticobiliary duct junction, choledochal cyst, and of course hepatic arteries

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