The gallbladder contains multiple shadowing calculi. The common bile duct measures 4mm. Although no CBD stone is seen, this does not definitively exclude choledocholithiasis.
The liver has slight increased echogenicity, with no focal liver lesions and no intrahepatic duct dilation. Decreased echogenicity within the liver at the gallbladder fossa is consistent with focal fatty sparing.
Conclusion
Cholelithiasis, with no convincing evidence of cholecystitis.