The bile cholesterol saturation index is determined by

A 44-year-old woman who has previously undergone cholecystectomy presents with intermittent right upper quadrant pain that seems biliary in origin. Her liver function tests have been abnormal during episodes of pain, and her bile duct is dilated to 1.5 cm on magnetic resonance cholangiopancreatography. Which of the following is most appropriate?

What is the first-line therapeutic option of choice for a partial (not circumferential) distal bile duct injury identified 48 hours after surgery?

A patient has a confirmed diagnosis of sphincter of Oddi dysfunction and has failed medical management. Each of the following is an appropriate intervention EXCEPT:

A 64-year-old male is TPN-dependent 2-weeks status post bowel resection for perforated duodenal ulcer. He develops right upper quadrant pain, and abdominal ultrasound suggests acute acalculous cholecystitis. Which are correct risk factors for the development of acalculous cholecystitis?

Following uneventful laparoscopic cholecystectomy, the final pathology shows a T1a adenocarcinoma in the wall of the gallbladder opposite to the gallbladder fossa wall. Definitive surgical treatment includes

A 65-year-old man with a history of cholecystitis previously managed by percutaneous cholecystostomy (3 years ago), coronary artery disease status post drug-eluting stent placement (most recently 2 years ago), chronic obstructive pulmonary disease, and dyslipidemia presents with a high-grade small bowel obstruction. Nonoperative management by nasogastric decompression is unsuccessful, and the patient is taken to the operating room for exploration. A firm, stonelike, mobile intraluminal mass is palpated in the distal ileum, 10 cm proximal to the ileocecal valve. The bowel appears mildly dilated and well perfused. What is the correct next maneuver?

Which of the following ultrasound findings best describe cholesterolosis of the gallbladder?

A 63-year-old woman has severe jaundice and back pain. She has been losing weight for three months. Workup reveals obstructive jaundice secondary to a distal common bile duct tumor. Among the following, the preoperative laboratory test most likely to be abnormal is:

When performing a choledochotomy during a laparoscopic or open bile duct exploration, how should the incision be made?

A 75-year-old man presents to the emergency department when his primary care physician ordered laboratory testing after he was noted to have scleral icterus and jaundice. The patient's total bilirubin level is 5.2 mg/dL and his alkaline phosphatase level is 327 U/L. He has had low-grade abdominal pain over the past few days but attributed it to his chronic irritable bowel syndrome. He has had no prior surgeries and reports he is otherwise healthy. He takes a statin for high cholesterol. His vital signs on presentation are temperature 101.5^oF, heart rate 98 beats per minute, and blood pressure 115/86 mm Hg. Which of the following is the appropriate imaging test to order for this patient?

A 52-year-old woman with a history of a distal gastrectomy and Roux-en-Y gastrojejunostomy presents with biliary sphincter of Oddi dysfunction. You have elected to perform a transduodenal sphincteroplasty. Which of the following is typically a component of this procedure?