What are the recommended initial investigations for a patient presenting with suspected gallstones?

Recommended initial investigations for suspected gallstones include:

• Offer liver function tests to assess for biliary obstruction or liver involvement.
• Perform an abdominal ultrasound scan to detect gallstones and evaluate the gallbladder and biliary tree.
• If ultrasound does not detect common bile duct stones but there is a dilated bile duct and/or abnormal liver function tests, consider magnetic resonance cholangiopancreatography (MRCP).
• If MRCP is inconclusive, consider endoscopic ultrasound (EUS) for further evaluation.
• In cases of suspected acute cholecystitis, additional blood tests such as white blood cell count, C-reactive protein, and serum amylase should be performed alongside ultrasound.

These investigations help confirm the diagnosis and guide further management or referral.

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