title: Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis.
abstract: BACKGROUND
  Extrahepatic cholestasis that is caused by benign and malignant diseases has been reported to increase liver stiffness (LS), as measured by transient elastography (TE).
  
  
  OBJECTIVE
  The aim of this study was to evaluate LS in patients with extrahepatic cholestasis due to choledocholithiasis before and after endoscopic sphincterotomy and stone removal.
  
  
  METHODS
  LS was measured by TE (Fibroscan) in patients with extrahepatic cholestasis that was caused by choledocholithiasis before and 1 month after endoscopic sphincterotomy and successful stone removal.
  
  
  RESULTS
  We studied 12 patients (7 females, 5 males), aged 36 to 76 years (mean age 57.1 ± 11.6 years), with extrahepatic cholestasis that was caused by choledocholithiasis. LS was increased in all patients (range: 6.2-18.4 kPa; mean: 8.9 ± 3.5 kPa) before endoscopic therapy. Successful biliary drainage was effected by sphincterotomy and stone removal in all patients, which led to a significant decline in LS to 3.9-8.1 kPa (Mean: 5.6 ± 1.2 kPa; p < 0.001) within a mean observation time of 29 days. The decrease in LS values correlated significantly with a decline in serum total bilirubin levels (r = 0.691; p < 0.0001).
  
  
  CONCLUSIONS
  Extrahepatic cholestasis due to choledocholithiasis increases LS and should be excluded before assesing liver fibrosis by transient elastography.
authors.affiliation: Institute of Gastroenterology and Hepatology, Iasi, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Trifan
authors.forename: Catalin
authors.initials: C
authors.lastname: Sfarti
authors.forename: Camelia
authors.initials: C
authors.lastname: Cojocariu
authors.forename: Mihaela
authors.initials: M
authors.lastname: Dimache
authors.forename: Maria
authors.initials: M
authors.lastname: Cretu
authors.forename: Catalin
authors.initials: C
authors.lastname: Hutanasu
authors.forename: Carol
authors.initials: C
authors.lastname: Stanciu
references.citation: Hepatology. 2005 Jan;41(1):48-54
references.pmid: 15690481
references.citation: Hepatol Res. 2011 May;41(5):423-9
references.pmid: 21435129
references.citation: J Hepatol. 2008 Apr;48(4):606-13
references.pmid: 18222014
references.citation: Hepatology. 2006 Aug;44(2):513-4
references.pmid: 16871581
references.citation: Hepatology. 2008 Feb;47(2):592-5
references.pmid: 18098325
references.citation: Hepatology. 2003 Dec;38(6):1449-57
references.pmid: 14647056
references.citation: Dtsch Med Wochenschr. 2006 Dec 8;131(49):2765-9
references.pmid: 17136655
references.citation: N Engl J Med. 2001 Feb 15;344(7):495-500
references.pmid: 11172192
references.citation: Hepatology. 2006 Dec;44(6):1511-7
references.pmid: 17133503
references.citation: Gut. 2007 Jul;56(7):968-73
references.pmid: 17255218
references.citation: Hepatology. 2000 Sep;32(3):477-81
references.pmid: 10960438
references.citation: Hepatology. 2008 Feb;47(2):380-4
references.pmid: 18095306
references.citation: Gastroenterology. 2008 Apr;134(4):960-74
references.pmid: 18395077
references.citation: J Viral Hepat. 2007 May;14(5):360-9
references.pmid: 17439526
references.citation: Ultrasound Med Biol. 2003 Dec;29(12):1705-13
references.pmid: 14698338
references.citation: J Gastroenterol. 2009;44(5):439-46
references.pmid: 19308312
references.citation: Gastroenterology. 2005 Feb;128(2):343-50
references.pmid: 15685546
references.citation: Hepatology. 2005 Feb;41(2):257-64
references.pmid: 15660389
references.citation: Hepatology. 2008 Nov;48(5):1718-23
references.pmid: 18836992