■ 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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For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.