ABCB4 and gallbladder disease 1: Their clinical findings show that the phenotypic spectrum of ABCB4 mutations in either the homozygous or heterozygous state is associated with LPAC, including (i) clustering within families; (ii) early onset of biliary symptoms, often before the age of 40 years; (iii) gallbladder cholesterol gallstones; (iv) intrahepatic hyperechoic foci, intrahepatic sludge, microlithiasis, or macroscopic cholesterol gallstones in the intrahepatic bile ducts; and (v) a high risk of recurrence of biliary symptoms after cholecystectomy [108,109,110,111].