Inflammatory process caused by cholecystitis may be the reason for changing the functional tests of the liver, and these changes help reduce the risk of an Endoscopic Retrograde Cholangiopancreatography (ERCR) and predict stones in the bile ducts. The presented study was performed between October 2017 and December 2019 on 140 patients suffering from cholecystitis. This study sought to evaluate the role of liver function testing in diagnosing stones in the bile duct. Patients underwent surgically removing gallstones, then performing intravenous cholangiography for patients suspected of having biliary colic, and hepatic enzymes were measured from direct and total bilirubin, (ALP), Alanine Aminotransferases (ALT), and Aspartate Aminotrans ferases (ASTs) that were not mainly diagnosed. Based on the high level of hepatic enzymes, ALP, ALT, and AST did not have significant differences between the two study groups, so to make sure of the presence of stones, we rely on conducting ultrasound imaging before performing intravenous imaging of the bile duct ERCP.
Choledocholithiasis occurs most ordinarily, the eventuality of common biliary duct stones increases significantly with the age of patients. Our study aimed to is to preoperatively investigate the levels of liver function indexes and results of diagnostic imaging, and their role in the early diagnosis of choledocholithiasis in elderly patients. This study included patients referred to the surgical department of the V. V. Vinogradov state medical center in Moscow, for the periods between 2018 -2020. In this study, 127 patients were divided into two groups: the control group (104 patients), cases group (23 patients), and patients without choledocholithiasis intraoperatively, included the patients with choledocholithiasis intraoperatively. Laboratory markers were studied. The sample was congenerous for age and gender. Our results upon admission to hospital show in cases group biliary pancreatitis in 13%, obstructive jaundice in 30.4% and 91.3% abdominal pain in the right hypochondrium, obstructive jaundice was the clinical symptom with statistical significance (p < 0.05). Patients with choledocholithiasis had higher values of the gammaglutamyl transferase, alkaline phosphatase, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and bilirubin (p < 0.01). The diagnostic imaging for the diagnosis of choledocholithiasis showed that ultrasound imaging had elevated specificity. By studying the changes that occur in the liver enzymes, parallel to results of imaging diagnosis, confirming the diagnosis preoperative choledocholithiasis can be predicted. Gamma-glutamyltransferase showed elevated sensitivity, while alkaline phosphatase showed elevated specificity, ultrasound imaging showed elevated specificity.
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