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 of Applied Mathematics and Statistics Edorium Journal of Surgery 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

  • Mohamed Ali Baghdadi, "VALUE OF CRITICAL VIEW OF SAFETY TECHNIQUE IN LAPAROSCOPIC CHOLECYSTECTOMY", International Journal of Advanced Research, 2017 More
  • Mohamed Ali Baghdadi, "Outcome of obstetric anal sphincter injuries repair techniques", Wolters Kluwer, 2018 More
  • Mohamed Ali Baghdadi, "LAPAROSCOPY VERSUS LAPAROTOMY IN EVALUATION OF PENETRATING ABDOMINAL INJURIES", International Journal of Advanced Research, 2018 More
  • Mohamed Ali Baghdadi, "The suitable time of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in gallstonedisease-associated choledocholithiasis", Wolters Kluwer, 2019 More
  • Mohamed Ali Baghdadi, "Ligation of intersphincteric fistula tract technique in the management of anorectal fistula", Wolters Kluwer, 2019 More

Department Related Publications

  • Mohamed Mahmoud Mokhtar, "Comparison between the Bone Cutter With thermal Cautery, Conventional Method, Plastibell and Gomco for Circumcision in Neonates and Infants", THE EGYPTIAN JOURNAL OSPITAL MEDICIN, 2022 More
  • Sam Mohamed Ali Amr, "Ordinary Dressing versus Dressing with Total Cast Offloading in Management of Diabetic Foot Heel Ulcer, Comparative Study", Zagazig university, 2022 More
  • Salah Mansour Abdelaal, "Percutaneous trans-abdominal external looped needle with two holes in the trocar sheath for port-site closures in difficult obese cases", 2016 Japan Society for Endoscopic Surgery, 2016 More
  • Hamdoon Alhuseiny Mohamed Elsanhoty, "Surgical correction of main stem reflux in superficial venous system; does it improves the flow in incompetent perforating veins", مجلة الزقازيق, 1996 More
  • Salah Mansour Abdelaal, "Oncological safety of conservative axillary lymph node dissection in pathologically positive axilla: randomized controlled study", Life Science Journal 2017;14(11), 2017 More
Tweet