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dc.contributor.authorBjörnsson, Helgi K
dc.contributor.authorBjörnsson, Einar S
dc.date.accessioned2019-10-02T15:24:49Z
dc.date.available2019-10-02T15:24:49Z
dc.date.issued2019-09-03
dc.date.submitted2019
dc.identifier.citationA significant proportion of patients with choledocholithiasis have markedly elevated alanine aminotransferase. 2019, 1-5. doi: 10.1080/00365521.2019.1657177 Scand J Gastroenterolen_US
dc.identifier.issn1502-7708
dc.identifier.pmid31479284
dc.identifier.doi10.1080/00365521.2019.1657177
dc.identifier.urihttp://hdl.handle.net/2336/621091
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractObjective: To determine the frequency and nature of liver enzyme elevations among patients presenting with choledocholithiasis (CDL). Methods: A prospective study identified all patients with serum level of alanine aminotransferase (ALT) ≥500 U/L (normal levels: <70 U/L in men, <45 U/L in women) over 1 year. Additionally, other patients with CDL were identified during the same period retrospectively by diagnostic codes and ERCP procedures, providing data on all CDL patients. Symptoms, liver tests, history of cholecystectomy, and radiological imaging were analyzed. Patients with radiologically confirmed CDL or a clinical diagnosis of CDL were included. Results: During the study period, 110 patients had CDL, 60% women, mean age 65 years. Overall 86/110 (78%) had confirmed CDL on imaging and 24/110 (22%) clinically diagnosed. Overall 26% had undergone cholecystectomy, median bile duct diameter 10.0 mm, median maximal liver tests: ALT 436, ALP 226, bilirubin 60 μmol/L (<25). Overall 9/110 (8%) had ALT ≥1000, 43/110 (39%) ALT levels between 500 and 1000 IU/L and 58/110 (53%) had ALT <500 IU/L. Patients with ALT ≥1000 had smaller bile duct diameter of 7 versus 10 mm (p < .001) but similar proportions of cholecystectomies. In the multivariate analysis age, maximal AST and maximal bilirubin were independent predictors of ALT >500. Maximal AST and bile duct diameter were independent predictors of ALT >1000. Conclusions: Approximately 8% of patients with CDL had markedly elevated ALT. These patients had smaller bile duct diameter. Pronounced ALT elevation is a part of the clinical spectrum of CDL.en_US
dc.language.isoenen_US
dc.publisherTaylor & Francisen_US
dc.relation.urlhttps://www.tandfonline.com/doi/full/10.1080/00365521.2019.1657177en_US
dc.subjectBiliary-clinicalen_US
dc.subjectERCPen_US
dc.subjectcholedocholithiasisen_US
dc.subjectliver enzymesen_US
dc.subjectGallrásen_US
dc.subjectEnsímen_US
dc.subjectLifuren_US
dc.subject.meshCholedocholithiasisen_US
dc.titleA significant proportion of patients with choledocholithiasis have markedly elevated alanine aminotransferase.en_US
dc.typeArticleen_US
dc.contributor.department1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, The National University Hospital of Iceland , Reykjavik , Iceland. 2 Faculty of Medicine, University of Iceland , Reykjavik , Iceland.en_US
dc.identifier.journalScandinavian Journal of Gastroenterologyen_US
dc.rights.accessLandspitali Access - LSH-aðganguren_US
dc.departmentcodeGAS12
dc.source.journaltitleScandinavian journal of gastroenterology


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