Mei Y, Chen L, Zeng PF, Peng CJ, Wang J, Li WP, Du C, Xiong K, Leng K, Feng CL, Jia JH. Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. World J Clin Cases 2019; 7(2): 137-144 [PMID: 30705891 DOI: 10.12998/wjcc.v7.i2.137]
Corresponding Author of This Article
Kai Leng, PhD, Chief Doctor, Department of Hepatopancreatobiliary Surgery, the Third Affiliated Hospital of Zunyi Medical University, No. 98 Fenghuang Load, Zunyi 563000, Guizhou Province, China. lengkai4757zsyy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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Mei Y, Chen L, Zeng PF, Peng CJ, Wang J, Li WP, Du C, Xiong K, Leng K, Feng CL, Jia JH. Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. World J Clin Cases 2019; 7(2): 137-144 [PMID: 30705891 DOI: 10.12998/wjcc.v7.i2.137]
World J Clin Cases. Jan 26, 2019; 7(2): 137-144 Published online Jan 26, 2019. doi: 10.12998/wjcc.v7.i2.137
Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis
Yong Mei, Li Chen, Peng-Fei Zeng, Ci-Jun Peng, Jun Wang, Wen-Ping Li, Chao Du, Kun Xiong, Kai Leng, Chun-Lin Feng, Ji-Hu Jia
Yong Mei, Peng-Fei Zeng, Jun Wang, Chao Du, Kun Xiong, Kai Leng, Chun-Lin Feng, Ji-Hu Jia, Department of Hepatopancreatobiliary Surgery, the Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Li Chen, Diagnostics Laboratory, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Ci-Jun Peng, Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Author contributions: Mei Y and Chen L contributed equally to this work; Mei Y, Chen L, Zeng PF and Peng CJ carried out the studies, participated in study design, and drafted the manuscript; Wang J, Li WP, Du C, Xiong K, Leng K, Feng CL and Jia JH participated in data collection and performed the statistical analyses; All authors read and approved the final manuscript.
Supported bythe Guizhou Provincial Department of Health Science and Technology Fund, No. GZWJKJ2014-2-151; the Science and Technology Fund of Guizhou Province, No. QKH LH [2016] 7421; and the Zunyi Science and Technology Research and Development Fund, No. ZSKHS [2016] 06.
Institutional review board statement: The study was approved by the Ethics Committee of the Third Affiliated Hospital of Zunyi Medical University, No. ZSYYLL118.
Informed consent statement: All clinical data were collected with informed consent obtained from study participants.
Conflict-of-interest statement: All authors declare that they have no any conflicts of interest.
Corresponding author: Kai Leng, PhD, Chief Doctor, Department of Hepatopancreatobiliary Surgery, the Third Affiliated Hospital of Zunyi Medical University, No. 98 Fenghuang Load, Zunyi 563000, Guizhou Province, China. lengkai4757zsyy@163.com
Telephone: +86-851-28923927 Fax: +86-851-28923927
Received: October 4, 2018 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
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
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.
Research objectives
To investigate the diagnostic value of abnormal serum gamma-glutamyltransferase (GGT) levels in asymptomatic choledocholithiasis secondary to cholecystolithiasis.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
