AIM/ BACKGROUND: Elevated liver enzymes are observed occasionally in patients with acute cholecystitis who do not have choledocholithiasis. The etiology and mechanism of this phenomenon are not well known. We aimed to compare the clinical characteristics between acute cholecystitis with and without choledocholithiasis in patients with elevated liver enzymes. PATIENTS AND METHODS: The medical records of acute cholecystitis patients who underwent cholecystectomy between January 2001 and October 2011 were retrospectively reviewed. We retrieved data of patients who showed abnormal liver enzymes and underwent endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, or intraoperative cholangiography. RESULTS: We analyzed clinical characteristics and comorbidities in 424 patients. Among 424 cholecystectomy patients with abnormal liver enzymes, 178 (42%) patients did not have choledocholithiasis and 246 (58%) patients had choledocholithiasis. The median AST, ALT, and total bilirubin were 47, 82.5 IU/dl, and 1.21 mg/dl, respectively, in patients without choledocholithiasis and 58, 96 IU/dl, and 1.53 mg/dl, respectively, in patients with choledocholithiasis. In a multivariate logistic regression analysis, fatty liver [odds ratio (OR): 0.218; P<0.001], radiologic findings (OR: 0.414; P=0.001), and the level of total bilirubin (OR: 1.410; P=0.001) were independent predictors of choledocholithiasis. CONCLUSION: Elevated liver enzymes in patients with cholecystitis who do not have choledocholithiasis are correlated with the presence of fatty liver and the severity of radiologic finding.
AIM/ BACKGROUND: Elevated liver enzymes are observed occasionally in patients with acute cholecystitis who do not have choledocholithiasis. The etiology and mechanism of this phenomenon are not well known. We aimed to compare the clinical characteristics between acute cholecystitis with and without choledocholithiasis in patients with elevated liver enzymes. PATIENTS AND METHODS: The medical records of acute cholecystitispatients who underwent cholecystectomy between January 2001 and October 2011 were retrospectively reviewed. We retrieved data of patients who showed abnormal liver enzymes and underwent endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, or intraoperative cholangiography. RESULTS: We analyzed clinical characteristics and comorbidities in 424 patients. Among 424 cholecystectomy patients with abnormal liver enzymes, 178 (42%) patients did not have choledocholithiasis and 246 (58%) patients had choledocholithiasis. The median AST, ALT, and total bilirubin were 47, 82.5 IU/dl, and 1.21 mg/dl, respectively, in patients without choledocholithiasis and 58, 96 IU/dl, and 1.53 mg/dl, respectively, in patients with choledocholithiasis. In a multivariate logistic regression analysis, fatty liver [odds ratio (OR): 0.218; P<0.001], radiologic findings (OR: 0.414; P=0.001), and the level of total bilirubin (OR: 1.410; P=0.001) were independent predictors of choledocholithiasis. CONCLUSION: Elevated liver enzymes in patients with cholecystitis who do not have choledocholithiasis are correlated with the presence of fatty liver and the severity of radiologic finding.
Authors: L Ansaloni; M Pisano; F Coccolini; A B Peitzmann; A Fingerhut; F Catena; F Agresta; A Allegri; I Bailey; Z J Balogh; C Bendinelli; W Biffl; L Bonavina; G Borzellino; F Brunetti; C C Burlew; G Camapanelli; F C Campanile; M Ceresoli; O Chiara; I Civil; R Coimbra; M De Moya; S Di Saverio; G P Fraga; S Gupta; J Kashuk; M D Kelly; V Koka; H Jeekel; R Latifi; A Leppaniemi; R V Maier; I Marzi; F Moore; D Piazzalunga; B Sakakushev; M Sartelli; T Scalea; P F Stahel; K Taviloglu; G Tugnoli; S Uraneus; G C Velmahos; I Wani; D G Weber; P Viale; M Sugrue; R Ivatury; Y Kluger; K S Gurusamy; E E Moore Journal: World J Emerg Surg Date: 2016-06-14 Impact factor: 5.469
Authors: Itamar Feldman; Lena Feldman; Dvorah S Shapiro; Gabriel Munter; Amos M Yinnon; Reuven Friedman Journal: Isr J Health Policy Res Date: 2020-08-03
Authors: Michele Pisano; Niccolò Allievi; Kurinchi Gurusamy; Giuseppe Borzellino; Stefania Cimbanassi; Djamila Boerna; Federico Coccolini; Andrea Tufo; Marcello Di Martino; Jeffrey Leung; Massimo Sartelli; Marco Ceresoli; Ronald V Maier; Elia Poiasina; Nicola De Angelis; Stefano Magnone; Paola Fugazzola; Ciro Paolillo; Raul Coimbra; Salomone Di Saverio; Belinda De Simone; Dieter G Weber; Boris E Sakakushev; Alessandro Lucianetti; Andrew W Kirkpatrick; Gustavo P Fraga; Imitaz Wani; Walter L Biffl; Osvaldo Chiara; Fikri Abu-Zidan; Ernest E Moore; Ari Leppäniemi; Yoram Kluger; Fausto Catena; Luca Ansaloni Journal: World J Emerg Surg Date: 2020-11-05 Impact factor: 5.469