TY - JOUR
T1 - Normal preoperative levels of gamma-glutamyltransferase predict the absence of common bile duct stones in patients scheduled for laparoscopic cholecystectomy
T2 - a retrospective cohort study
AU - Khan, Noman Ahmed
AU - Siraj, Muhammad Imran
AU - Rajput, Iqra Anees
AU - Memon, Zahid Ali
AU - Ali, Rehan Ramzan
AU - Ursani, Asna
AU - Anees, Muhammad Muthar
AU - Kumar, Karan
AU - Naina,
AU - Kumar, Rahul Robaish
AU - Kumar, Rahul
AU - Shahab, Ramsha
AU - Asghar, Muhammad Sohaib
N1 - Publisher Copyright:
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Objective: Laparoscopic cholecystectomy, nowadays, is considered the gold standard option for management in patients diagnosed with symptomatic cholelithiasis. Nevertheless, some patients may have coexisting choledocholithiasis, which manifests later in life with grave complications such as cholangitis and pancreatitis. The objective of this study is to evaluate the role of preoperative gamma-glutamyltransferase (GGT) in predicting choledocholithiasis in patients undergoing laparoscopic cholecystectomy. Method: A total of 360 patients with symptomatic cholelithiasis based on diagnosis aided with abdominal ultrasound were included in the study. The study design was a retrospective cohort. Patients were evaluated based on a comparison between findings of per-operative cholangiogram and laboratory measure of GGT. Result: The mean age of study participants was 47.22 (± 28.41) years. Mean GGT levels were 121.54 (± 87.91) U/l. One hundred (27.7%) participants had raised GGT. But only 19.4% had been diagnosed with filling defect positive on cholangiogram. The predictability of GGT for positive cholangiogram is statistically significant at less than 0.001 with an area under the curve of 0.922 (0.887–0.957), sensitivity of 95.7%, specificity of 88.6%, and accuracy of 90%. The standard error reported (0.018) was found to be relatively low. Conclusion: Based on the provided information, it is concluded that GGT plays an important role in predicting the coexistence of choledocholithiasis in symptomatic cholelithiasis and can be used in the setting where the facility of per-operative cholangiogram is not available.
AB - Objective: Laparoscopic cholecystectomy, nowadays, is considered the gold standard option for management in patients diagnosed with symptomatic cholelithiasis. Nevertheless, some patients may have coexisting choledocholithiasis, which manifests later in life with grave complications such as cholangitis and pancreatitis. The objective of this study is to evaluate the role of preoperative gamma-glutamyltransferase (GGT) in predicting choledocholithiasis in patients undergoing laparoscopic cholecystectomy. Method: A total of 360 patients with symptomatic cholelithiasis based on diagnosis aided with abdominal ultrasound were included in the study. The study design was a retrospective cohort. Patients were evaluated based on a comparison between findings of per-operative cholangiogram and laboratory measure of GGT. Result: The mean age of study participants was 47.22 (± 28.41) years. Mean GGT levels were 121.54 (± 87.91) U/l. One hundred (27.7%) participants had raised GGT. But only 19.4% had been diagnosed with filling defect positive on cholangiogram. The predictability of GGT for positive cholangiogram is statistically significant at less than 0.001 with an area under the curve of 0.922 (0.887–0.957), sensitivity of 95.7%, specificity of 88.6%, and accuracy of 90%. The standard error reported (0.018) was found to be relatively low. Conclusion: Based on the provided information, it is concluded that GGT plays an important role in predicting the coexistence of choledocholithiasis in symptomatic cholelithiasis and can be used in the setting where the facility of per-operative cholangiogram is not available.
KW - choledocholithiasis
KW - gamma-glutamyltransferase (GGT)
KW - laparoscopic cholecystectomy
KW - per-operative cholangiogram
KW - symptomatic cholelithiasis
UR - http://www.scopus.com/inward/record.url?scp=85161495278&partnerID=8YFLogxK
U2 - 10.1097/MS9.0000000000000281
DO - 10.1097/MS9.0000000000000281
M3 - Article
AN - SCOPUS:85161495278
SN - 2049-0801
VL - 85
SP - 701
EP - 705
JO - Annals of Medicine and Surgery
JF - Annals of Medicine and Surgery
IS - 4
ER -