Abstract: Objective The aim of this study was to summarize enhanced CT scan features of patients with cholelithiasis and their guidance on clinical decision-making. Methods 160 patients with cholelithiasis were encountered in our hospital between May 2022 and April 2024, and all of them underwent enhanced CT scan. Clinical management included laparoscopic cholecystectomy (LC), endoscopic retrograde cholangiopancreatography (ERCP) and antibiotics. Results Of the 160 patients with cholelithiasis, cholecystolithiasis was found in 46 cases, cholangiolithiasis in 54 cases and cholecystolithiasis/cholangiolithiasis in 60 cases; in our series, incidence of bile duct dilatation was 60.0%, intrahepatic density changes was 30.0% and bile duct wall thickening was 32.5%; incidences of intrahepatic bile duct dilatation in patients with cholangiolithiasis and cholecystolithiasis/cholangiolithiasis were 77.8% and 80.0%, both much higher than 21.7%(P＜0.05)in patients with cholecystolithiasis, incidences of bile duct wall thickening were 51.9% and 60.0%, both much higher than 17.4% (P＜0.05)in patients with cholecystolithiasis; incidences of complicated cholangitis in patients with cholangiolithiasis and cholecystolithiasis/cholangiolithiasis were 44.4% and 46.7%, both much higher than 8.7%(P＜0.05) in patients with cholecystolithiasis, incidences of liver abscess were 11.1% and 13.3%, both much higher than 0.0%(P＜0.05)in patients with cholecystolithiasis; all patients in our series recovered after personalized LC, ERCP and/or supporting therapy. Conclusion Enhanced CT scan could clearly display imaging features of patients with cholelithiasis, which might provide a reliable basis for disease classification, complications assessment and individualized treatment decision-making.

Key words: Cholelithiasis, Enhanced CT scan, Imaging feature, Clinical decision-making, Individualized treatment