Biliary sludge and microlithiasis: are we covering the full spectrum of lithogenic biliary disorders?

Abstract

We read with great interest the recent consensus by Żorniak et al ,1 which provides a long-awaited standardised definition of biliary sludge and microlithiasis. 30 internationally recognised experts participated in a structured survey and voting process, leading to proposed definitions: microlithiasis as ‘hyperechoic calculi≤5 mm with acoustic shadowing’, biliary sludge as ‘hyperechoic material without acoustic shadowing, sedimenting in the dependent part of the gallbladder’ and biliary stones as ‘calculi>5 mm with acoustic shadowing’. This represents an important step towards harmonising terminology and enabling future clinical studies. In routine endoscopic ultrasound (EUS) practice, …