Elevated Liver Enzymes in Patients with Cholecystitis

Fikry, Amir; Kassem, Abdallah; Shahin, Doaa; Shabana, H

doi:10.11648/j.js.20140203.11

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…As previously observed in the literature,81324 LFTs including total bilirubin, SGOT and ALP can vary in AC patients with or without CBDS. They are not only affected by the presence of CBDS but also by the severity and acuteness of AC 25. Our study showed that both AC + and AC − patients could present with normal results.…”

Section: Discussionmentioning

confidence: 53%

“…There are several mechanisms may be responsible for the false negative and false positive LFTs in AC patients. In theory, CBD stones cause biliary obstruction with increased intra-biliary pressure due to hindrance of bile flow and subsequent peri-ductal inflammation and hepatocellular injury with elevated LFTs 81025. However, partially obstructing stones may not cause elevated bilirubin levels thus generating false negative values 713.…”

Section: Discussionmentioning

confidence: 99%

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Utility of liver function tests in acute cholecystitis

Zgheib

Wakil

Shayya

et al. 2019

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims Common bile duct stones (CBDS) affect the management of acute cholecystitis (AC). This study aims to investigate the utility of liver function tests (LFTs) in predicting the presence of CBDS in AC patients. Methods Retrospective cohort study of adult patients with AC found in the American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2016. Patients were classified into two groups, without CBDS (AC − ) and with CBDS (AC + ). LFT results namely total bilirubin, SGOT and ALP were collected and categorized into normal and abnormal with the cut-offs of 1.2 mg/dl for total bilirubin, 40 U/L for SGOT and 120 IU/L for ALP. Measures of diagnostic accuracy for individual and combinations of LFTs were computed. Results A total of 32,839 patients were included in the study, with 8,801 (26.8%) AC + and 24,038 (73.2%) AC − patients. Their mean age was 52.4 (±18.6) years and over half (59.1%) were females. Mean LFT results were significantly higher in the AC + group for total bilirubin (1.82 vs 0.97), SGOT (110.9 vs 53.3) and ALP (164.4 vs 102.3) ( p <0.0001). The proportions of abnomal LFTs were significantly higher in the AC + group for total bilirubin (47.7% vs 20.2%), SGOT (62.8% vs 27.1%) and ALP (56.6% vs 21.0%) ( p <0.0001). Among AC + , the odds of having abnormal results for bilirubin, SGOT and ALP were found to be 3.61, 4.54 and 4.90 times higher than among AC − , respectively. Conclusions Abnormal LFTs are strong predictors for the presence of CBDS in patients with AC. Normal LFTs should be interpreted with caution as some patients with AC and CBDS might not present with characteristic abnormalities in results.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Utility of liver function tests in acute cholecystitis

Zgheib

Wakil

Shayya

et al. 2019

Ann Hepatobiliary Pancreat Surg

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“…Moreover, on one hand, among patients without CBDS, CC cases have been reported to have significantly lower LFTs when compared to AC cases [13] . On the other hand, a study by Peng WK, Sheikh Z, Paterson-Brown S et al, on patients without CBDS showed no significant differences in LFTs between AC and CC patients [14] .…”

Section: Introductionmentioning

confidence: 95%

Liver function tests as predictors of common bile duct stones in acute cholecystitis patients with a chronic history

Zgheib¹,

Wakil²,

Souky³

et al. 2021

Medicine

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“…The changes in post-operative liver function tests (LFTs) after LC may also result from the potential hepatotoxicity of anesthetic drugs used during the procedure, and the thermal energy used for haemostatic control during gallbladder removal [6]. For instance, potential hepatocellular damage is identified with the elevation of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) [7,8]. Increased level of alkaline phosphatase (ALP) is a result of biliary duct obstruction while haemolysis or bile flow obstruction increases bilirubin level.…”

Section: Introductionmentioning

confidence: 99%

Effect of laparoscopic cholecystectomy on liver enzymes in Arabian goats

Al-Abbadi¹

2019

J Pre Clin Clin Res.

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Introduction and objective. Laparoscopic cholecystectomy (LC) has become the gold standard management option for benign gallbladder disease and cholelithiasis. However, there are physiological consequences with the induction of pneumoperitoneum during LC, resulting in the reduction of hepatic blood flow which leads to the elevation of liver enzymes. This study aimed to evaluate changes in liver enzymes after LC and determine its clinical effects on goats. Materials and method. This prospective study was conducted in six goats via LC using four-trocar procedure to determine alteration in liver enzymes. Vital parameters, including rectal temperature, respiratory rate, and heart rate were monitored twice daily for abnormalities. Blood samples were collected pre-operatively and at 2, 12, and 36 hours, and on day 3 and day 7 after surgery to compare liver enzyme alterations (aspartate transaminase [AST], alanine transaminase [ALT], alkaline phosphatase [ALP], bilirubin, total protein, and albumin). Results. Average time for LCs was 25 minutes. Biochemical estimation revealed a significant increase (p≤0.05) in total (baseline: 0.27±0.03 mg/dL vs. at 2 h: 0.57±0.02 mg/dL and 12 h: 1.05±0.20 mg/dL) and direct bilirubin (baseline value: 0.12±0.02 mg/dL vs. 2 h: 0.23±0.02 mg/dL and 12 h: 0.23±0.02 mg/dL). Indirect bilirubin increased significantly (p≤0.05) after 12 hours post-operatively. Total protein and globulin decreased significantly (p≤0.05) throughout. AST and ALT levels increased (p≤0.05) after 2, 12, 36 hours, and on day 3 post-operatively. ALP increased after 2 hours and thereafter decreased significantly (p≤0.05). Conclusion. A considerable rise in the liver enzymes of the goat after LC due to changes in hepatic blood flow was observed.

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Elevated Liver Enzymes in Patients with Cholecystitis

Cited by 4 publications

References 14 publications

Utility of liver function tests in acute cholecystitis

Utility of liver function tests in acute cholecystitis

Liver function tests as predictors of common bile duct stones in acute cholecystitis patients with a chronic history

Effect of laparoscopic cholecystectomy on liver enzymes in Arabian goats

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