Diagnostic value of liver function tests in bile duct obstruction.
Serological tests may be of value in differentiating acute and chronic bile duct obstruction because the rate of alteration of hepatic cellular integrity and function will affect the rate of cellular product release. In a canine model the common bile duct was obstructed either suddenly (N = 7) or gradually (N = 5). A control group (N = 5) had the common bile duct dissected free from the surrounding tissues. Blood was taken before and 1, 2, 4, 7, 11, 14, 17, 21, and 28 days after initiating obstruction. Serum alkaline phosphatase, bilirubin, aspartate aminotransferase, alanine aminotransferase, ornithine carbamyl transferase, and gamma-glutamyl transferase levels were significantly greater with sudden compared to gradual occlusion, and the values were larger than those in the control. The range of values of alkaline phosphatase, bilirubin, and aspartate aminotransferase did not overlap in the acute and chronic groups at specific times. Serum albumin and total protein were normal in all groups. The magnitude of alkaline phosphatase, aspartate aminotransferase, and bilirubin elevation may help in the differentiation of acute and chronic biliary obstruction.
Stein
T A
TA
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York 11042.
Burns
G P
GP
Wise
L
L
D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D002779:Cholestasis / Q000175:diagnosis*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis; D003137:Common Bile Duct Diseases / Q000175:diagnosis; D004285:Dogs; D005069:Evaluation Studies as Topic; D008111:Liver Function Tests; D009954:Ornithine Carbamoyltransferase / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
D001798:Blood Proteins; D009954:Ornithine Carbamoyltransferase; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin