This study suggests that, despite an evolution in the resolution of ultrasound imaging, there has not been a corresponding improvement in sensitivity. There is a false positive rate of 16% which remains unchanged since the early 1990s.

T-tube placement into the common bile duct (CBD) is most commonly performed after CBD exploration for cholelithiasis or repair of an iatrogenic CBD injury. Bile peritonitis occurring after T-tube removal is generally considered an exceedingly rare complication, which on occurrence necessitates urgent intervention. No clear guidance exists on the timing of T-tube removal and its relationship to the development of bile peritonitis. This study aimed to determine the incidence of bile peritonitis after T-tube removal, its relationship to the timing of removal and how knowledge of this can help the general surgeon.

We therefore conclude that laparoscopic surgery for patients with acalculous gallbladder disease is effective in symptom control and allowing patients to return to their normal lifestyle.

PPV for the identification of true gallbladder polyps using ultrasound remains very low at 0.18. We suggest that more advanced imaging modalities are required to improve this figure and enhance patient management.

The authors report a case of a 79-year-old female who presented with signs and symptoms of acute cholecystitis. She was taken to theatre within 24 h of acute admission to undergo laparoscopic cholecystectomy. The gallbladder was found to have undergone torsion upon its mesentery leading to its infarction and necrosis. Laparoscopic cholecystectomy was performed, and the patient made an uneventful recovery.