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Routine liver function tests and serum amylase determinations after biliary lithotripsy: are they necessary?
B W Goodacre1, D E Malone, J S Fache
1Department of Radiology, University of British Columbia, Vancouver, Canada.
AJR. American Journal of Roentgenology
|October 1, 1990
Summary
Routine liver function tests and serum amylase after biliary extracorporeal shock-wave lithotripsy (BESWL) show little value. Abnormalities and complications were infrequent, and tests did not predict outcomes, suggesting cost savings by abandoning routine testing.
Area of Science:
- Gastroenterology
- Nephrology
- Medical Technology
Background:
- Biliary extracorporeal shock-wave lithotripsy (BESWL) can cause soft-tissue damage.
- Routine laboratory monitoring is standard post-BESWL to detect complications.
Purpose of the Study:
- To evaluate the utility of routine liver function tests and serum amylase levels in predicting complications after BESWL.
- To determine if laboratory abnormalities correlate with shock-wave parameters or clinical outcomes.
Main Methods:
- Analysis of laboratory data (liver function tests, serum amylase) from 311 patients undergoing BESWL.
- Correlation of laboratory results with shock-wave parameters, complications, and reported pain levels.
Main Results:
- 19% of patients showed laboratory abnormalities, mostly mild and transient.
- Clinically significant complications occurred in 5 patients (1.6%), with no correlation to routine tests.
- Severe pain correlated with abnormal lab findings, but not the degree of abnormality.
Conclusions:
- Routine post-BESWL laboratory tests are nonspecific and do not reliably predict complications.
- These tests offer little value in the absence of clinical signs and symptoms.
- Abandoning routine biochemical tests may lead to cost savings.