Final answer:
For patients with gallstones but no fever or elevated WBC count, a HIDA scan and MRCP are the recommended imaging procedures to further evaluate the biliary system and gallbladder function. ERCP is more invasive and typically reserved for potential therapeutic interventions.
Step-by-step explanation:
In patients who have gallstones shown on ultrasound but do not present with fever or an elevated white blood cell count, further imaging procedures might be considered to evaluate the biliary tree and gallbladder function.
One such procedure is the Hepatobiliary iminodiacetic acid (HIDA) scan, also known as cholescintigraphy, where a radioactive tracer is used to assess the function of the gallbladder and bile ducts. Another non-invasive procedure is the Magnetic resonance cholangiopancreatography (MRCP), which provides detailed images using MRI technology and can evaluate the biliary and pancreatic ducts.
However, Endoscopic retrograde cholangiopancreatography (ERCP) should be used cautiously, as it is more invasive and typically reserved for cases where therapeutic intervention is needed or other tests have not been conclusive.
While a Computed tomography (CT) scan provides detailed images and may detect complications related to gallstones, it is not typically the first line of imaging unless there are concerns for an acute abdominal process other than gallstones. An MRI could offer additional imaging details but may not be as targeted for gallbladder function as an MRCP or HIDA scan. Therefore, HIDA scan and MRCP are generally the recommended imaging procedures in this clinical scenario, depending on the specific clinical question being addressed.
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