Biliary sludge refers to a viscous mixture of small particles derived from bile.

[1][2] Biliary sludge has been associated with pregnancy, rapid weight loss, total parenteral nutrition, drugs such as ceftriaxone and octreotide, solid organ transplantation, and gastric surgery.

[2] It is presumed that because the gallbladder is unable to effectively empty, the biliary sludge can start to accumulate.

[1] For those who are poor surgical candidates, endoscopic sphincterotomy may be performed to reduce the risk of developing pancreatitis.

[1] The clinical course of biliary sludge can do one of three things: (1) it can resolve completely, (2) wax and wane, or (3) progress to gallstones.