Predicting the Diagnosis of Choledocholithiasis in Elderly Patients by Assessing Hepatic Functions

Abstract

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.