Table 2.

Checklist for the interpretation of early computed tomography (CT) after laparoscopic, converted and open cholecystectomy

Feature	Comments
Assess pleuropulmonary changes at lung bases	Atelectasis/pneumonia/pleural effusion?
Scrutinise operated abdominal wall at (either) laparotomic incision or trocar access sites	Wound haematoma? Herniation of fat or viscera? Fluid collection or abscess collections → suggest wound infection
Scrutinise peritoneal cavity	Within a few days, mild residual air (particularly after laparotomy) and minimal fluid are expected findings Significant peritoneal effusion → concern for bile leakage or (exceptional) visceral injury Spilled gallstones? Masses suspicious for retained surgical sponge?
Drainage tubes present?	Mostly after converted and open cholecystectomy Best visualised using thick-slab maximum intensity projection (MIP) reconstructions Report presence, course and distal tip position
Scrutinise surgical bed	Minimal fluid or blood at gallbladder fossa is normal Common (non-infected) collections – measure size and attenuation Abscess w/o spilled gallstones? Haematoma?
Search for signs of bleeding	Haematoma?  - Usual site infrahepatic  - Uncommon: haemoperitoneum, paraduodenal
	Active haemorrhage (use MIP reconstructions + comparison between precontrast, arterial and portal venous phase)
Biliary tract status	Intrahepatic bile ducts: diffuse/segmental dilatation? Remnant cystic duct Common bile duct: calibre, filling defects, position of clips Abnormal findings → suggest magnetic resonance cholangiopancreatography (MRCP)
Assess splenic, portal and mesenteric veins	Postoperative thrombosis? (most usually in septic patients)
Assess gastrointestinal tract	Stomach and/or small bowel distension generally reflects ileus