Laboratory Examinations of Diseases of the Gallbladder

Acute inflammation of the gallbladder (GB) can be diagnosed by CBC findings along with image findings, and the severity of inflammation can be predicted by serum level of CRP. Serum level of CRP can also be used to predict the possibility of conversion from laparoscopic cholecystectomy to open surgery. Serum tumor markers (CA 19-9 and CEA) for GB cancer have low sensitivity and specificity. Discovery of novel tumor markers for early detection and prognostic prediction of GB cancer is in great demand. To date, the bile examination of GB diseases is not widely used, but further efforts in improving the methods and discovery of novel targets may prove to be valuable in the future. Serum IgG4 should be checked in patients with unusual GB wall thickening or GB mass. In patients with acalculous cholecystitis, especially in immunocompromised patients, uncommon pathogens (bacteria, fungus, virus, or parasite) should be considered as an etiology. To discover the role of Helicobacter in various GB diseases, further studies are warranted.