Acute transient hepatocellular injury in cholelithiasis and cholecystitis without evidence of choledocholithiasis

Table 1 Basic data of 186 patients with cholelithiasis and cholecystitis who underwent cholecystectomy (mean ± SD)

Cholecystectomy	CBD stones	Patients (M/F)	Age (yr)	ERCP	MRCP	IOC
Urgent	Yes	80 (43/37)	63.8 ± 16.2	47	3	61
	No	74 (33/41)	57.9 ± 15.9	42	0	34
Elective	Yes	10 (7/3)	59.8 ± 11.1	9	0	6
	No	22 (9/13)	58.2 ± 15.4	16	0	8
	Total	186	60.6 ± 15.9	114	3	109

CBD: Common bile duct; ERCP: Endoscopic retrograde cholangiopancreatography; MRCP: Magnetic resonance cholangiopancreatography; IOC: Intra-operative cholangiography.

Table 2 Liver tests in patients with cholelithiasis and cholecystitis who underwent cholecystectomy

Variable (normal range)	CBD stones (90)		No CBD stones (96)		P-value1
	mean ± SD (range)	Incidence of abnormal results	mean ± SD (range)	Incidence of abnormal results
AST (5-35 IU/L)	137.2 ± 131.8 (19-693)	84.40% (76/90)	62.9 ± 96.9 (10-670)	41.67% (40/96)	< 0.001
ALT (5-30 IU/L)	178.7 ± 159.0 (17-696)	95.55% (86/90)	83.8 ± 109.5 (12-566)	51.04% (49/96)	< 0.001
ALK-P (40-133 IU/L)	204.7 ± 122.7 (14-672)	71.11% (64/90)	118.8 ± 92.5 (38-615)	22.92% (22/96)	< 0.001
D. Bilirubin (0.0-0.4 mg/dL)	2.16 ± 2.08 (0.1-12)	88.89% (80/90)	0.64 ± 1.01 (0-5.0)	32.29% (31/96)	< 0.001
T. Bilirubin (0.2-1.3 mg/dL)	3.81 ± 3.27 (0.3-18.6)	76.67% (69/90)	1.50 ± 1.68 (0.2-9.3)	27.08% (26/96)	< 0.001

¹Statistical analysis using the Student’s t-test. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALK-P: Alkaline phosphatase; D.: Direct; T.: Total.

Table 3 Liver tests before and 2 wk to 1 mo after cholecystectomy in 82 patients without CBD stones (mean ± SD)

Value (normal range)	Before	After
AST (5-35 IU/L)	62.89 ± 96.85	30.95 ± 15.14
ALT (5-30 IU/L)	83.80 ± 109.50	35.95 ± 26.05
ALK-P (40-120 IU/L )	118.83 ± 92.53	118.79 ± 78.05
D. Bilirubin (0.0-0.4 mg/dL)	0.64 ± 1.00	0.37 ± 0.31
T. Bilirubin (0.2-1.3 mg/dL)	1.50 ± 1.68	0.90 ± 0.58

Table 4 Comparison of basic data between gangrenous cholecystitis and simple cholecystitis in patients who underwent urgent surgery (total 74 patients) (mean ± SD)

Variable	Gangrenous cholecystitis (15)	Simple cholecystitis (59)	P-value	95% CI
				Lower	Upper
Age	64.9 ± 11.8	56.1 ± 16.4	0.053	-17.83	0.13
Hospital stay (d)	13.3 ± 5.6	11.0 ± 8.7	0.334	-7.01	2.41
AST (5-35 IU/L)	61.5 ± 74.4	72.8 ± 116.3	0.721	-51.76	74.42
ALT (5-30 IU/L)	72.3 ± 66.8	110.8 ± 187.1	0.438	-59.78	136.74
ALK-P (40-120 IU/L )	128.1 ± 68.9	103.7 ± 48.5	0.116	-55	6.19
D. Bilirubin (0.0-0.4 mg/dL)	1.23 ± 1.31	0.41 ± 0.70	0.001	-1.31	-0.33
T. Bilirubin (0.2-1.3 mg/dL)	2.66 ± 1.97	1.14 ± 1.27	< 0.001	-2.35	-0.69
WBC (3400-10000/μL)	12840.0 ± 5273.9	9480.2 ± 4681.3	0.018	-6128	-591.6