Acute hepatocellular injury is a commonly encountered phenomenon in patients with cholelithiasis and concomitant common bile duct (CBD) stones. However, in clinical practice, it seemed to occur also in cholelithiasis patients without evidence of CBD stones. Its incidence and final outcome necessitated clarification.
A research article to be published on August 14, 2009 in the World Journal of Gastroenterology addresses this question. The research team, led by Dr. Shou-Chuan Shih from Mackay Memorial Hospital (Taiwan, China) investigated acute transient hepatocellular injury in patients with cholelithiasis and cholecystitis but no evidence of choledocholithiasis.
The medical records of patients with cholelithiasis who underwent cholecystectomy between July 2003 and June 2007 were retrospectively reviewed. Imaging studies to detect CBD stones were performed in 186 patients, who constituted the study population. Biochemical liver tests before and after surgery, and with the presence or absence of CBD stones were analyzed.
They found that, in 96 patients with cholelithiasis and cholecystitis without evidence of CBD stones, 49 (51.0%) had an alanine aminotransferase level elevated to 2-3 times the upper limit of normal, and 40 (41.2%) had an elevated aspartate aminotransferase level. Similar manifestations of hepatocellular injury were, as would be expected, even more obvious in the 90 patients with CBD stones. These markers of hepatocellular injury resolved almost completely within 2 week to 1 moth after cholecystectomy. Compared to 59 patients with histologically less severe cholecystitis.
The result indicated that acute hepatocel lular injury in cholelithiasis and cholecystitis without choledocholithiasis is mild and transient . Hyperbilirubinemia and leukocytosis may predict severe inflammatory changes in the gallbladder.
Reference: Chang CW, Chang WH, Lin CC, Chu CH, Wang TE, Shih SC.Acute transient hepatocellular injury in cholelithiasis and cholecystitis without evidence of choledocholithiasis.World J Gastroenterol 2009 August;15(30):3788-3792
http://www.wjgnet.com/1007-9327/15/3788.asp
Correspondence to: Shou-Chuan Shih, MD, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Chung-Shan N. Road, Taipei, Taiwan. China. mmhgiman@gmail.com
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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