Clinical value of elevated gamma-glutamyltransferase and/ or alkaline phosphatase in non-jaundiced symptomatic gallstone disease

Faculty Medicine Year: 2017
Type of Publication: ZU Hosted Pages:
Authors:
Journal: International journal Aadvanced Research Edorium J Surg 2017;4:34–40.Edorium J Surg 2017;4:34–40. Volume:
Keywords : Clinical value , elevated gamma-glutamyltransferase and/ or alkaline    
Abstract:
Aims: To evaluate the importance of elevated gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) as predictor factors for choledocholithiasis in non-jaundiced symptomatic gallstone disease. Methods: This study was carried out in the Department of General Surgery, Zagazig University Hospitals in the period between February 2016 and February 2017. This study was carried out upon 20 patients diagnosed as symptomatic cholecystitis and met the inclusion criteria i.e., elevated GGT and/or ALP levels with normal bilirubin level and normal common bile duct (CBD) by ultrasonography. Results: We found that 20 diagnosed cases of symptomatic gallstone disease in the study and they were predominantly females (80%). In preoperative liver function tests, serum bilirubin was normal and ranged from 0.1–1 mg/dl. All cases had GGT level above 60 IU/L and ranged from 82–609 IU/L with mean standard deviation was (mean±SD: 298.3±184.08 IU/L). ALP level ranged from 57–520 IU/L with mean standard deviation was (mean±SD: 210.9±132.82 IU/L) and 30% of these cases had normal level (≤ 130 IU/L). Magnetic resonance cholangiopancreatography (MRCP) was done for all the cases of the study. 85% of the cases were normal and 15% of the cases were narrow. Statistically, there was highly significant difference decreasing in GGT and ALP levels among postoperative (p < 0.001). Conclusion: Gamma-glutamyltransferase (GGT) and alkaline phosphatase are sensitive but not specific to choledocholithiasis because of their multiple sources. The value of their estimation preoperatively is that their elevation increase the suspicious of CBD stone or pathology. Their elevation provokes the surgeon to assess the state of CBD by more accurate diagnostic tool as MRCP. Most of the cases (85%) with elevated GGT and/ or ALP but with normal bilirubin and ultrasound findings of CBD had no stones at CBD at time of their evaluation. But the small sector (15%) had pathology indicated intervention by endoscopic retrograde cholangiopancreatography (ERCP) and if neglected before laparoscopic cholecystectomy, there would be morbidity on the patient.
   
     
 
       

Author Related Publications

  • Walid Ahmed Abdel Hadi Hassan, "VALUE OF CRITICAL VIEW OF SAFETY TECHNIQUE IN LAPAROSCOPIC CHOLECYSTECTOMY", International journal Aadvanced Research, 2017 More
  • Walid Ahmed Abdel Hadi Hassan, "Independent perioperative predictive risk factors for the anastomotic leak after emergency bowel resection anastomosis", International Surgery Journal, 2019 More
  • Walid Ahmed Abdel Hadi Hassan, "SLUG & YKL-40 Immunohistochemical Expression in Invasive Ductal Carcinoma of the Breast (IDC); Clinicopathological Values", Chronicle of Medicine and Surgery, 2018 More
  • Walid Ahmed Abdel Hadi Hassan, "ALL IN ONE TECHNIQUE VERSUS LICHTENSTEIN TECHNIQUE FOR TREATMENT OF INGUINAL HERNIA IN ZAGAZIG UNIVERSITY HOSPITALS.", International journal Aadvanced Research, 2019 More
  • Walid Ahmed Abdel Hadi Hassan, "LAPAROSCOPY AS A SUITABLE AND SAFE ALTERNATIVE TO OPEN SURGERY IN MANAGEMENT OF PERFORATED PEPTIC ULCER: A COMPARATIVE STUDY", International journal Aadvanced Research, 2019 More

Department Related Publications

  • Fady Mehaney Habib Salamh, "Double mesh technique (mesh plug and onlay) in repair of lumbar incisional hernia: a novel technique", Wolters Kluwer - Medknow, 2018 More
  • Mohamed Farouk Amin Mahmoud, "Prognostic Value of Percentage of Positive to Total Excised Axillary Lymph Nodes in Egypt with Triple Negative Breast Cancer: Multiple-Centers Experience.", International Journal of Life Sciences, 2018 More
  • Mohamed Mahmoud Mokhtar, "Comparison Of Onlay Versus Sublay Mesh Repair For Management of Paraumbilical Hernia", Zagazig University Medical Journal, 2020 More
  • Mohamed Mahmoud Mokhtar, "Changing the innate consensus about mesh fixation in trans-abdominal preperitoneal laparoscopic inguinal hernioplasty in adults: Short and long term outcome. Randomized controlled clinical trial", International Journal of Surgery, 2020 More
  • Ashraf Ismail Mesref esmaiel, "Fistulectomy and primary repair of wound and analsphincter by Lasheen’s sutures for high perianal fistula", Edorium Journal of Surgery, 2015 More
Tweet