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. 2023 Mar 27;85(4):701-705.
doi: 10.1097/MS9.0000000000000281. eCollection 2023 Apr.

Normal preoperative levels of gamma-glutamyltransferase predict the absence of common bile duct stones in patients scheduled for laparoscopic cholecystectomy: a retrospective cohort study

Noman Ahmed Khan  1 , Muhammad Imran Siraj  2 , Iqra Anees Rajput  1 , Zahid Ali Memon  1 , Rehan Ramzan Ali  2 , Asna Ursani  2 , Muhammad Muthar Anees  3 , Karan Kumar  4 , Naina  4 , Rahul Robaish Kumar  4 , Rahul Kumar  5 , Ramsha Shahab  6 , Muhammad Sohaib Asghar  7
Affiliations

Normal preoperative levels of gamma-glutamyltransferase predict the absence of common bile duct stones in patients scheduled for laparoscopic cholecystectomy: a retrospective cohort study

Noman Ahmed Khan et al. Ann Med Surg (Lond). .

Abstract

Laparoscopic cholecystectomy, nowadays, is considered the gold standard option for management in patients diagnosed with symptomatic cholelithiasis. Nevertheless, some patients may have coexisting choledocholithiasis, which manifests later in life with grave complications such as cholangitis and pancreatitis. The objective of this study is to evaluate the role of preoperative gamma-glutamyltransferase (GGT) in predicting choledocholithiasis in patients undergoing laparoscopic cholecystectomy.

Method: A total of 360 patients with symptomatic cholelithiasis based on diagnosis aided with abdominal ultrasound were included in the study. The study design was a retrospective cohort. Patients were evaluated based on a comparison between findings of per-operative cholangiogram and laboratory measure of GGT.

Result: The mean age of study participants was 47.22 (±28.41) years. Mean GGT levels were 121.54 (±87.91) U/l. One hundred (27.7%) participants had raised GGT. But only 19.4% had been diagnosed with filling defect positive on cholangiogram. The predictability of GGT for positive cholangiogram is statistically significant at less than 0.001 with an area under the curve of 0.922 (0.887-0.957), sensitivity of 95.7%, specificity of 88.6%, and accuracy of 90%. The standard error reported (0.018) was found to be relatively low.

Conclusion: Based on the provided information, it is concluded that GGT plays an important role in predicting the coexistence of choledocholithiasis in symptomatic cholelithiasis and can be used in the setting where the facility of per-operative cholangiogram is not available.

Keywords: choledocholithiasis; gamma-glutamyltransferase (GGT); laparoscopic cholecystectomy; per-operative cholangiogram; symptomatic cholelithiasis.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Receiver operating characteristic statistics for area under the curve of raised gamma-glutamyltransferase for positive cholangiogram.
See this image and copyright information in PMC

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