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Open research questions in Gallbladder and Bile Duct Disorders

496 gap statements mined from Gallbladder and Bile Duct Disorders papers in our 7.9M-paper local library, which holds 2,603 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Prospective multicenter validation is warranted to confirm generalizability of the HBA-3 score and refine clinically relevant cutoffs. Future studies should assess how the three key predictors—HU, BMI, and age—interact with implant characteristics such as cage footprint, material, and expandable designs, as well as surgical techniques including end-plate preparation and fixation strategies.

    The HBA-3 score: a simple bedside tool to predict cage subsidence after TLIF · 2026 · DOI

  • This study has several limitations. To our knowledge, however, few studies have directly compared DL-based respiratory-triggered MRCP with both conventional respiratory-triggered MRCP and highly accelerated breath-hold CS MRCP within the same patient cohort.

    Deep learning–based respiratory-triggered magnetic resonance cholangiopancreatography: comparison with conventional respiratory-triggered and breath-hold magnetic resonance cholangiopancreatography · 2026 · DOI

  • It is important to be aware of the epidemiology and imaging findings of this rare clinical entity, even though an evidence-based management strategy has not yet been established.

    Prevalence and CT features of calyceal diverticula detected using Gd-EOB-DTPA-enhanced liver MR imaging · 2026 · DOI

  • The median follow-up duration of 30 months, although adequate for assessing medium-term biliary complications, remains insufficient to fully capture very late stone recurrences or the decay of sphincter function over a decade or longer.

    Laparoscopic common bile duct exploration and primary suture versus ERCP combined with laparoscopic cholecystectomy for choledocholithiasis: a retrospective comparative study · 2026 · DOI

  • Future research will focus on developing automated localization modules to reduce manual pre-processing, as well as conducting prospective multi-center studies with larger cohorts to further enhance clinical scalability and model robustness. Future studies incorporating real-world prevalence distributions and prospective validation are warranted to further assess model robustness and clinical applicability.

    Deep learning model for automated identification of ventrally positioned right hepatic artery in contrast-enhanced computed tomography of pediatric congenital biliary dilatation: development and clinical application · 2026 · DOI

  • Future prospective, multicenter studies integrating standardized imaging findings, objective measures of operative complexity, and surgeon-related variables are warranted to more comprehensively determine how surgical timing should be integrated into decision-making after PTGBD.

    Timing of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage and the risk of bailout surgery: a restricted cubic spline analysis · 2026 · DOI

  • Despite substantial advances in EUS-GBD, several critical knowledge gaps remain. The long-term durability beyond 3–5 years is poorly defined, and the true incidence of late stent-related adverse events, fistula-related complications, and symptom recurrence remains uncertain.

    Evolution of gallbladder drainage: a comprehensive review from percutaneous to endoscopic ultrasound-guided approaches · 2026 · DOI

  • This is very cost-effective, but further research is needed to validate the benefits of simultaneous SPVE and sclerotherapy. The modalities of bile duct sclerotherapy and selective portal vein embolization for the management of type D leakages have previously been described in case reports with limited numbers of patients, inconsistent results, and often as monotherapy.

    Combined selective portal vein embolization and excluded bile duct sclerotherapy (SPEEDS) in the treatment of excluded bile ducts · 2026 · DOI

  • Prospective studies with standardized access strategies and adjustment for relevant procedural and patient-related factors are warranted to further clarify the comparative role of ultrasound- and fluoroscopy-guided PTBD.

    Comparative Outcomes of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage (PTBD) Due to Malignant Obstructive Jaundice: A Single-Center Retrospective Analysis · 2026 · DOI

  • This review is limited by the quality of the underlying evidence. A large or easily punctured gallbladder alone is insufficient; a credible physiological pathway from the intrahepatic ducts to the gallbladder must be established.

    Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Distal Biliary Obstruction: Current Evidence, Technical Considerations, and Future Directions · 2026 · DOI

  • Future research should focus on prospective multicenter studies, long-term follow-up, and standardized care protocols to further improve the quality of management for this condition.

    Clinical Characteristics, ERCP Management, and Early Adverse Events Among Patients with Choledocholithiasis at a Romanian Tertiary Referral Center: A Retrospective Cohort · 2026 · DOI

  • Future studies conducted in larger populations and with prospective designs are warranted to validate these findings and enhance their generalizability.

    Incidence and clinical significance of biliary and pancreatic duct variations on magnetic resonance cholangiopancreatography · 2026 · DOI

  • Effectiveness and safety for EUS-RV, especially in patients with MDBO, remains unclear.

    Efficacy and safety of EUS-guided Rendezvous after failed ERCP. Retrospective comparison in malignant versus benign biliary disease · 2026 · DOI

  • SII may be a useful risk marker, but causal inference is limited by the cross-sectional design.

    Sex-stratified association between systemic immune-inflammation index and gallstone risk: a cross-sectional study in a Chinese adult population · 2026 · DOI

  • In dedicated acute cholecystitis cohorts, BDI rates did not differ, but evidence for advanced inflammation is scarce.

    Bile Duct Injury After Robotic Versus Laparoscopic Cholecystectomy: A Systematic Review of Comparative Studies, Including Acute Cholecystitis · 2026 · DOI

  • The optimal biliary reconstruction technique in this context remains controversial.

    Biliary Reconstruction in Liver Transplantation for Primary Sclerosing Cholangitis: Outcomes of an Anatomy-Driven Shift Towards Duct-to-Duct Anastomosis · 2026 · DOI

  • Based on our two cases showing spontaneous regression, further large-scale studies with a longer observation period are warranted.

    Prevalence and CT features of calyceal diverticula detected using Gd-EOB-DTPA-enhanced liver MR imaging · 2026 · DOI

  • The absence of procedural and imaging-related variables is an important limitation.

    Machine Learning Models for Predicting Response to Percutaneous Transhepatic Biliary Drainage in Malignant Obstructive Jaundice: A Retrospective Cohort Study · 2026 · DOI

  • Future large-scale studies are warranted to validate its clinical utility and to establish standardized diagnostic criteria.

    Prospective pilot study of functional assessment of the Sphincter of Oddi via cine-dynamic MRCP with selective inversion recovery pulse · 2026 · DOI

  • Despite its clinical relevance, biliary inflammation remains poorly characterized at the cellular and molecular levels.

    Histological, ultrastructural, and single-cell profiling reveal immune-mediated remodeling in gallbladder inflammation · 2026 · DOI

  • Both approaches have advantages and drawbacks, and there remains uncertainty about the optimal method in our setting.

    Management of Choledocholithiasis: Experience from a Tertiary Care Hospital in Bangladesh · 2026 · DOI

  • Alternative strategies include percutaneous drainage, EUS-guided biliary drainage, or surgical bypass, although no standard approach has been clearly established.

    Choledochoduodenostomy versus transpapillary stent by endoscopic retrograde cholangiopancreatography for preoperative biliary drainage before pancreatoduodenectomy: a French multicenter retrospective cohort study · 2026 · DOI

  • Our proposed approach to diagnosing OS dyskinesis is summarized in Figure 2. Figure 2. Procedure for diagnosing functional OS disorders. After excluding organic diseases using MRI, EUS, and duodenoscopy, the next step is to determine whether the pain is of biliopancreatic origin (typically postprandial pain occurring within 30 min, localized to the upper abdomen).

    Personalized Treatments for Functional Disorders of the Sphincter of Oddi: A Short Muscle with a Long History of Discussion and Controversies · 2026 · DOI

  • As a retrospective study, there was no standardization in how providers selected PC, cholecystectomy, or medical management.

    Emphysematous cholecystitis managed with percutaneous cholecystostomy compared to cholecystectomy or medical management: a 10-year single center experience · 2026 · DOI

  • The univariable analyses used sample-derived thresholds and did not account for correlations among institutional volume, staffing, center size, and hospital type.

    Endoscopic ultrasound service readiness across a provincial endoscopy network in Hubei, China: a cross-sectional institutional survey · 2026 · DOI

Most-cited papers in Gallbladder and Bile Duct Disorders

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Open questions raised by papers listed on this page include: (1) Prospective multicenter validation is warranted to confirm generalizability of the HBA-3 score and refine clinically relevant cutoffs (“The HBA-3 score: a simple bedside tool to predict cage subsidence after TLIF”, 2026); (2) It is important to be aware of the epidemiology and imaging findings of this rare clinical entity, even though an evidence-based management strategy has not yet been established (“Prevalence and CT features of calyceal diverticula detected using…”, 2026); (3) Future studies incorporating real-world prevalence distributions and prospective validation are warranted to further assess model robustness and clinical applicability (“Deep learning model for automated identification of ventrally positioned right…”, 2026); (4) This is very cost-effective, but further research is needed to validate the benefits of simultaneous SPVE and sclerotherapy (“Combined selective portal vein embolization and excluded bile duct…”, 2026); (5) Prospective studies with standardized access strategies and adjustment for relevant procedural and patient-related factors are warranted to further clarify the comparative role of ultrasound- and fluoroscopy-guided PTBD (“Comparative Outcomes of Ultrasound-Guided Versus Fluoroscopy-Guided…”, 2026). 496 gap statements have been mined from Gallbladder and Bile Duct Disorders papers in our 7.9M-paper local library, which holds 2,603 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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