Volume 2, Issue 3, June 2014, Page: 38-41
Elevated Liver Enzymes in Patients with Cholecystitis
Amir A. Fikry, Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Arafat A. Kassem, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Doaa Shahin, Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Hosam aldeen S. Shabana, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Received: May 9, 2014;       Accepted: May 15, 2014;       Published: May 30, 2014
DOI: 10.11648/j.js.20140203.11      View  3214      Downloads  740
Aims: To investigate changes in liver function tests in calcular cholecystitis (acute and chronic) and to relate that changes to cholecystitis. Methods: A retrospective study including 389 patients with clinical and sonographic evidence of cholecystitis with exclusion of other causes of elevated liver function tests, which are done preoperatively and four weeks postoperatively. Results: Increased liver function tests observed in both acute and chronic cholecystitis. The only significant differences between both groups were a higher bilirubin level (P= 0.001) and WBC (P= 0.018). Pre and post-cholecystectomy levels of AST, ALK-P and GGT were significantly changed (P= 0.001). Conclusion: Our study showed that the abnormal biochemical liver function tests resolved rapidly and spontaneously after cholecystectomy indicating transient hepatocellular injury with cholecystitis.
Cholecystitis, Liver function tests, Leucocytosis
To cite this article
Amir A. Fikry, Arafat A. Kassem, Doaa Shahin, Hosam aldeen S. Shabana, Elevated Liver Enzymes in Patients with Cholecystitis, Journal of Surgery. Vol. 2, No. 3, 2014, pp. 38-41. doi: 10.11648/j.js.20140203.11
Aydin C, Altaca G, Berber I, Tekin K, Kara M, Titiz I. Prognostic parameters for the prediction of acute gangrenous cholecystitis. J Hepatobiliary pancreat surg. 2000; 13: 155-159.
Cameron IC, Chadwick C, Phillips J, Johnson AG. Acute cholecystitis- room for improvement? Ann R Coll Engl., 2000; 84: 10-13.
Chang CC, Wang SS. Acute abdominal pain in the elderly. Int. J. Gerontol. 2007; (1): 77-82.
Chen CH, Yang PM, Huang GT, Lee HS, Sung JL, Sheu JC. Estimation of seroprevalence of hepatitis B virus and hepatitis C virus in Taiwan from a large scale survey of free hepatitis screening participants. J. Formos. Med Assoc. 2007; 106: 148-155.
Chen W C, Wen HC, Ching CL, Cheng HC, Tsarg EW, Shou CS. Acute tran-sient hepatocellular injury in cholelithiasis and cholecystitis without evidence of choledocholi-thiasis. World J. Gastroenterol. 2009; 15 (30): 3788- 3792.
Fagan SP, Awad SS, Rahwan K, Hira K, Aoki N, Itani KH, Berger DH. Prognostic factors for the development of gangrenous chole-cystitis. Am j surg 2003; 168( 5): 481-485.
Feher G, Lengyel G, Bla-zovics A. Oxidative stress in the liver and biliary tract diseases. Scand J Gastroenterol. Suppl 1998; 228: 38-46.
Fernandez M, Csendes A, Yarmuch J, Diaz H, Silva J. Management of common bile duct stones: The state of the art in 2000. Int surg. 2003; 88(3): 159-163.
Freitas ML, Bell RL, Duffy AJ. Choledocholithiasis: evolving standards for diagnosis and management. World J Ga-stroenterol 2006; 82: 12(20) 3162- 3167.
Froom P, Froom J. Elevated liver enzymes in a symptomatic patients. N. Engl. J. Med. 2000; 100: 295-298. Iranica 2011; 49(10):663-666.
Geraghty JM, Goldin RD. Liver changes associated with cholecystitis. J. Clin. Pathol. 1994; 47(5):457-460.
Habib L, Mirza MR, Ali Channa M, Wasty WH. Role of liver function tests in symptomatic cholelithiasis. J. Ayub. Med. Coll. Abbottabad.2009; 21(2): 117-119.
Henry JB. Clinical diagnosis and management by laboratory methods, 17th ed. WB Saunders Company, Philadelphia, 2001; 217-250. Iranica 2011; 49(10):663-666.
Kurzweil SM, Shapiro MJ, Andrus CH, Wittgen CM, Herrmann VM, Kamnski DL. Hyperbilirubinemia without CBD abnormalities and hyperamylasemia without pan-creatitis in patients with gallbladder disease. Arch. Surg.1994; 128(8): 829-833.
Menezes N, Marson LP, Debeaux AC, Muir IM, Auld CD. Prospective analysis of a scoring system to predict choledocholithiasis. Br. J. Surg. 2000; 87: 1167-1181.
Mohammad Z, Saeed K, Mohsen A. Mohammed HM. Role of liver function enzymes in diagnosis of choledocholithiasis in biliary colic patients. Acta Medica Iranica 2011; 49(10):663-666.
Mohan H. Textbook of pathology, 4th edition Jaypee Publisher, Delhi 2002; 84: 10-13.
Nathwani RA, Kumar SR, Reynolds TB, Kaplowitz N. Marked elevation in serum transaminases: an atypical presentation of choledocho-lithiasis. Am J Gastroenterol. 2005; 100: 295-298.
Padda MS, Singh SJ, Tang SJ, Rocky DC. Liver function test patterns in patients with acute calculus cholecystitis and/or choledocholithiasis. Aliment Pharmacol. Ther. 2009; 29(9): 1011-8.
Peng WK, Sheikh Z, Paterson BS, Nixon SJ. Role of liver function tests in predicting CBD stones in acute calculus cholecystitis. Br J Surg 2005; 92: 1241-7.
Periera LJC, Jakobs R, Busnello JV, Benz C, Blaya C, Riemann JF. The role of serum liver enzymes in the diagnosis of choledocholithiasis. Hepatogastroenterology 2000; 47(36): 1522- 1525.
Tranter SE, Thompson MH. Spontaneous passage of bile duct stones: frequency of occurrence and relation to clinical presentation. Ann R Coll Surg Engl. 2003; 85(3): 174-177.
Thapa PB, Maharjan DK, Suwal B, Byanjankar B, Singh DR. Serum Gam-ma-glutamyl transpeptidase and alkaline phosphatase in acute cholecystitis. J. Nepal Health Res Counc 2010, 8(17): 78- 81.
Browse journals by subject