Abstract:
BACKGROUND:Gradual normalization of conventional liver function tests occurs in a majority of patients with extrahepatic biliary obstruction following adequate biliary drainage. Abnormal recovery pattern of liver function has been reported in up to 70% of these patients and there is scarcity of relevant information about this. The purpose of the present paper was to identify variables predictive of abnormal recovery pattern of liver function tests after surgical repair of benign biliary stricture. METHODS:Patient data, disease-related characteristics and serial liver function tests were prospectively collected in 64 patients with post-cholecystectomy bile duct strictures undergoing hepaticojejunostomy. Hepatic histology (fibrosis, portal inflammation, ductular proliferation and cholestasis) was independently graded by two pathologists using a previously validated scale. A cut-off limit of longer than 2 weeks for normalization of liver function tests following definitive surgical repair was considered abnormal. The patients were accordingly dichotomized into groups. Univariate and multivariate analysis was performed. RESULTS:Fourteen patients (22%) each had abnormal recovery pattern of serum bilirubin and serum alanine aminotransferase (ALT) levels while 13 (20%) had abnormal recovery pattern of serum alkaline phosphatase (SAP) levels. Multivariate analysis revealed basal serum bilirubin level was an independent predictor of abnormal recovery pattern of serum bilirubin level while basal ALT level as well as degree of hepatic fibrosis were independent predictors of abnormal recovery of serum ALT level. Similarly, basal SAP level and degree of hepatic fibrosis were independent predictors of abnormal recovery of SAP level. CONCLUSIONS:Basal values of liver function tests and degree of hepatic fibrosis are the most important predictors of abnormal recovery pattern of liver function following adequate biliary decompression in patients with post-cholecystectomy bile duct stricture.
journal_name
J Gastroenterol Hepatoljournal_title
Journal of gastroenterology and hepatologyauthors
Negi SS,Chaudhary Adoi
10.1111/j.1440-1746.2005.03890.xsubject
Has Abstractpub_date
2005-10-01 00:00:00pages
1533-7issue
10eissn
0815-9319issn
1440-1746pii
JGH3890journal_volume
20pub_type
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