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Routine testing of liver function after biliary-enteric anastomosis has no clinical relevance
P W Plaisier1, R L van der Hul, J S Laméris
1Department of General Surgery, University Hospital Rotterdam, Rotterdam, The Netherlands.
Hepato-Gastroenterology
|July 21, 2001
Summary
Elevated liver function tests are common after biliary-enteric anastomosis but do not predict cholangitis. Routine lab screening for these elevations is not recommended in follow-up care.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Outcomes
Background:
- Biliary-enteric anastomosis is frequently associated with elevated liver function tests.
- The clinical significance of these elevations, particularly concerning recurrent cholangitis, requires investigation.
Purpose of the Study:
- To determine if elevated liver function tests post-biliary-enteric anastomosis correlate with recurrent cholangitis.
- To identify risk factors for elevated liver function tests and cholangitis in patients with biliary-enteric anastomosis.
Main Methods:
- Retrospective evaluation of 32 patients who underwent biliary-enteric anastomosis for benign biliary disease.
- Follow-up included clinical assessment, liver function tests, ultrasonography, and 99mTc-HIDA scintigraphy.
Main Results:
- Elevated liver function tests were observed in 69% of patients during follow-up (median 45 months).
- Male sex was an independent risk factor for elevated liver function tests (OR: 10.9, P < 0.05).
- Only 22% of patients experienced a single episode of cholangitis; no risk factors were identified.
Conclusions:
- Elevated liver function tests are common after biliary-enteric anastomosis for benign disease and do not predict cholangitis.
- Routine laboratory screening for elevated liver function tests is not recommended for follow-up of biliary-enteric anastomosis.