Habib Lubna, Mirza Masoom Raza, Ali Channa Muhammad, Wasty Wajahat Hussain
Department of Surgery, Hamdard College of Medicine & Dentistry/Hamdard University Hospital, Pakistan.
J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):117-9.
Cholelithiasis is a common problem in west as well as in developing nations and its incidence is continuously rising. It has become routine to order LFT's in every patient undergoing cholecystectomy for symptomatic cholelithiasis.
To evaluate the usefulness of routine Liver Function Tests (LFT's) in patients with symptomatic cholelithiasis.
This prospective descriptive study was conducted from August 2006 to July 2007 at Department of Surgery, Hamdard University Hospital and other private hospitals. All patients presenting with symptomatic cholelithiasis with no past and present history ofjaundice, pancreatitis, cholangitis and normal calibre common bile duct on ultrasonography. The relevant data regarding history, clinical examination, LFT's and ultrasound findings were recorded and analysed.
Out of 124 patients, 102 (82.25%) were female and 22 (17.74%) were male with the mean age 43 years (range 20 to 76 years). Majority of patients, 110 (88.71%) presented as chronic calculous cholecystitis, 12 (9.68%) as acute calculous cholecystitis and 2 (1.61%) with biliary colic. In 108 (87.10%) patients, labelled as group A, LFT's were with in normal range. In this group most of the patients, 103 (95.37%) were those who presented as chronic calculous cholecystitis. Rest of the 5 patients (4.63%) with normal LFT's were those who presented as acute calculous cholecystitis. In 16 patients (12.90%), labelled as group B, LFT's were found deranged. In this group 7 (43.75%) patients presented as acute calculous cholecystitis, 7 (43.75%) as chronic calculous cholecystitis and 2 (12.5%) with biliary colic. Bilirubin was found elevated in 2, AST in 4 and alkaline phosphatase in all patients. None of these patients in either group had dilated CBD on preoperative ultrasound examination and per operatively (in open surgery) CBD dilatation or palpable stones were not found.
A routine LFT's in preoperative assessment of uncomplicated symptomatic cholelithiasis usually comes out normal and it is not a good predictive marker for the detection of silent CBD calculi.
胆石症在西方国家以及发展中国家都是一个常见问题，且其发病率在持续上升。对于有症状性胆石症而接受胆囊切除术的每位患者，常规进行肝功能检查（LFT）已成为惯例。
评估常规肝功能检查（LFT）在有症状性胆石症患者中的作用。
这项前瞻性描述性研究于2006年8月至2007年7月在哈姆达德大学医院外科及其他私立医院进行。所有有症状性胆石症患者，既往及目前均无黄疸、胰腺炎、胆管炎病史，且超声检查显示胆总管管径正常。记录并分析有关病史、临床检查、LFT及超声检查结果的相关数据。
124例患者中，女性102例（82.25%），男性22例（17.74%），平均年龄43岁（范围20至76岁）。大多数患者，110例（88.71%）表现为慢性结石性胆囊炎，12例（9.68%）为急性结石性胆囊炎，2例（1.61%）为胆绞痛。108例（87.10%）患者，标记为A组，LFT在正常范围内。在该组中，大多数患者，103例（95.37%）表现为慢性结石性胆囊炎。其余5例（4.63%）LFT正常的患者表现为急性结石性胆囊炎。16例（12.90%）患者，标记为B组，LFT异常。在该组中，7例（43.75%）患者表现为急性结石性胆囊炎，7例（43.75%）为慢性结石性胆囊炎，2例（12.5%）为胆绞痛。2例患者胆红素升高，4例患者AST升高，所有患者碱性磷酸酶均升高。两组中这些患者在术前超声检查及手术中（开放手术）均未发现胆总管扩张，也未触及结石。
在无并发症的有症状性胆石症术前评估中，常规LFT通常结果正常，且它不是检测无症状胆总管结石的良好预测指标。
