ROLE OF LIVER FUNCTION TESTS IN SYMPTOMATIC CHOLELITHIASIS
AbstractBackground: Cholelithiasis is a common problem in west as well as in developing nations and itsincidence is continuously rising. It has become routine to order LFT’s in every patient undergoingcholecystectomy for symptomatic cholelithiasis. Objective: To evaluate the usefulness of routineLiver Function Tests (LFT’s) in patients with symptomatic cholelithiasis. Methods: This prospectivedescriptive study was conducted from August 2006 to July 2007 at Department of Surgery, HamdardUniversity Hospital and other private hospitals. All patients presenting with symptomatic cholelithiasiswith no past and present history of jaundice, pancreatitis, cholangitis and normal calibre common bileduct on ultrasonography. The relevant data regarding history, clinical examination, LFT’s andultrasound findings were recorded and analysed. Results: Out of 124 patients, 102 (82.25%) werefemale and 22 (17.74%) were male with the mean age 43 years (range 20 to 76 years). Majority ofpatients, 110 (88.71%) presented as chronic calculous cholecystitis, 12 (9.68%) as acute calculouscholecystitis and 2 (1.61%) with biliary colic. In 108 (87.10%) patients, labelled as group A, LFT’swere with in normal range. In this group most of the patients, 103 (95.37%) were those who presentedas chronic calculous cholecystitis. Rest of the 5 patients (4.63%) with normal LFT’s were those whopresented as acute calculous cholecystitis. In 16 patients (12.90%), labelled as group B, LFT’s werefound deranged. In this group 7 (43.75%) patients presented as acute calculous cholecystitis, 7(43.75%) as chronic calculous cholecystitis and 2 (12.5%) with biliary colic. Bilirubin was foundelevated in 2, AST in 4 and alkaline phosphatase in all patients. None of these patients in either grouphad dilated CBD on preoperative ultrasound examination and per operatively (in open surgery) CBDdilatation or palpable stones were not found. Conclusion: A routine LFT’s in preoperative assessmentof uncomplicated symptomatic cholelithiasis usually comes out normal and it is not a good predictivemarker for the detection of silent CBD calculi.Keywords: Cholelithiasis, Gall stones, Choledocholithiasis, Common bile duct, Liver functiontest, Cholecystectomy, Laparoscopic, Symptomatic, Uncomplicated
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