title: Serum gamma glutamyl transferase and alkaline phosphatase in acute cholecystitis.
abstract: BACKGROUND
  The serum level of gamma glutaryl transferase and alkaline phosphatase is raised in acute calculus cholecystitis and common bile duct stone. However, the rise in serum level of these enzymes in acute cholecystitis implies stone in the common bile duct is not well studied. Thus, it may lead to retained CBD stone on one side and unnecessary CBD exploration on the other during emergency laparoscopic cholecystectomy. The objective of the study is to predict presence of CBD stone by assessing serum level of gamma-glutamyltransferase (gamma-GT)and alkaline phosphatase.
  
  
  METHODS
  A prospective study was designed which included 40 patients with clinically diagnosed and radiologically confirmed acute cholecystitis and 40 patients who had choledocholithiasis with or without cholangitis. Their serumgamma glutaryl transferase and alkaline phosphatase were analyzed.
  
  
  RESULTS
  Both acute cholecystitis and CBD pathology had significant increase in alkaline phosphatase (p-value: 0.05). However, in acute cholecystitis there was 1.69±0.118 fold increase and in CBD pathology there was 2.5±0.57 fold increase in alkaline phosphatase than normal.(130 IU /L). There was no statistically significant difference ingamma- GT in both acute cholecystitis and CBD pathology(p-value: 0.390). However it increases by 2.8±0.47fold in acute cholecystitis and by 2.2±0.16 in CBD pathology(p value: 0.627).
  
  
  CONCLUSIONS
  Although there is rise in serumγ-GT and alkaline phosphatase level in acute cholecystitis and CBD stone,only more than 2.5 fold rise in serum alkaline phosphatase level predicts CBD stone.
authors.affiliation: Department of General Surgery, Kathmandu Medical College Teaching Hospital, Baburam Sadak, Kathmandu, Nepal. prabin_bt@rediff.mail,
authors.forename: P B
authors.initials: PB
authors.lastname: Thapa
authors.forename: D K
authors.initials: DK
authors.lastname: Maharjan
authors.forename: B
authors.initials: B
authors.lastname: Suwal
authors.forename: B
authors.initials: B
authors.lastname: Byanjankar
authors.forename: D R
authors.initials: DR
authors.lastname: Singh
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood* / Q000378:metabolism; D016022:Case-Control Studies; D002761:Cholangitis / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology; D042883:Choledocholithiasis / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology; D006305:Health Status Indicators; D006801:Humans; D008111:Liver Function Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D005723:gamma-Glutamyltransferase / Q000097:blood* / Q000378:metabolism
chemical_list: D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase