Published online Jan 26, 2019. doi: 10.12998/wjcc.v7.i2.137
Peer-review started: October 4, 2018
First decision: October 18, 2018
Revised: November 22, 2018
Accepted: December 21, 2018
Article in press: December 21, 2018
Published online: January 26, 2019
Processing time: 114 Days and 19.2 Hours
Cholelithiasis is a commonly seen disease in hepatobiliary surgery departments in China. In cholecystolithiasis patients treated by surgery, the incidence of secondary choledocholithiasis is up to 10%-15%. However, most cases of secondary choledocholithiasis often have no symptoms and are missed in diagnosis.
It is of great clinical significance to explore the methods for the early diagnosis of asymptomatic secondary choledocholithiasis to develop rational surgical protocols, avoid postoperative residual stones and reduce related complications.
To investigate the diagnostic value of abnormal serum gamma-glutamyltransferase (GGT) levels in asymptomatic choledocholithiasis secondary to cholecystolithiasis.
In this retrospective cohort study, the clinical data of 829 cholelithiasis patients were collected. Serum liver function indexes were detected in both groups, and the ROC curves were constructed for markers showing statistical significances.
The overall incidence of asymptomatic choledocholithiasis secondary to cholecystolithiasis was 18.2%. The results of liver function indexes, including serum aspartate aminotransferase, alanine aminotransferase, direct bilirubin and total bilirubin levels showed no significant differences between the two groups. However, serum GGT and alkaline phosphatase levels were significantly higher in the observation group than in the control group.
In the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis, abnormally elevated serum GGT levels have important value; and the combination of serum GGT and alkaline phosphatase had better diagnostic performance.
Physicians should be vigilant about the possibility of secondary asymptomatic choledocholithiasis when the serum GGT level reaches the cutoff value. Timely and proper interventions should be performed to avoid aggravation of the disease.