Acute cholecystitis. Frequency of stones in the common duct and predictive value of liver function tests

Two hundred and forty-three patients aged under 75 years with acute calculous cholecystitis treated by early surgery were studied with a view to investigating the frequency of choledocholithiasis and the predictive value of routine liver function tests (bilirubin, alkaline phosphatase, alanine aminotransferase). 7% had stones in the common duct, but 33% had hyperbilirubinaemia. In less than 10% of the latter could be hyperbilirubinaemia be attributed to common bile duct stones. It was concluded that the frequency of common bile duct stones in acute cholecystitis was low, and that patients often had signs of impaired liver function which was of no help in diagnosing the presence of stones in the common duct.