Ultrasound scanning (USS)
USS is the investigation of choice for initial imaging of the gallbladder disease. The normal gallbladder wall appears as a pencil-thin line on USS in the fasting patient.

Ultrasound scanning is most sensitive at detecting gallstones and provision of information on gallbladder thickness. Stones that are undetected by ultrasound are typically smaller than 2 mm and/or located in the neck of the gallbladder. Magnetic Resonance Imaging (MRI) is superior to ultrasound in localizing stones in the cystic duct and gallbladder neck.

Cholangiography is imaging of the ductal system to delineate the biliary anatomy or to rule out ductal stones. It is done if the patient is jaundiced, had pancreatitis or scans and/or blood tests suggesting the possibility of a ductal stone.