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CRITICAL EVALUATION OF CLINICOPATHOLOGICAL STUDY ON LIVER FUNCTIONS IN POSTCHOLECYSTECTOMY CASES COMPARED TO PREOPERATIVE STATUS

Swapan Kumar Datta, Shubhra Datta, Prasanta Das

Abstract


Introduction: Gall stones are quite common in the general population. It is said that gallstones are more common in fat, fertile (multiparous), flatulent, females in their forties. A wide variety of symptoms are associated with gall stones but not all of them are relieved after cholecystectomy, raising doubts whether these symptoms, were in fact, due to gall bladder function  itself or due to certain  other factors.

Hence, a comparative study of liver function tests enveloping the two main schools of approach that is open and laparoscopic techniques will no doubt prove to be invaluable in order to verify whether or not a surgical intervention has an effect upon the improvement of liver functions in patients afflicted with calculous cholelithiasis.

This study was also carried out to ascertain preoperative symptoms associated with gall bladder stones and outcome of the removal of gall bladder for improvement in these symptoms or appearance of new symptoms during follow up period.

Material & Methods: This Prospective study was conducted in a series of 100 cases of chronic calculus cholecystitis with or without choledocholithiasis from October 2009 to September 2011. A detailed clinical history, clinical examination, investigations were carried out (imaging and blood tests), cholecystectomy performed & results of postoperative investigations compared with preoperative values.

Results and Discussion: In present study the highest incidence was found to be between the ages of 31 to 50 years. The results indicate that a major proportion of pre-operative symptoms associated with gall stones were relieved after cholecystectomy. Serum bilirubin, AST and ALT levels were raised significantly in laparoscopic cholecystectomy in comparison to minilap and conventional cholecystectomy from preoperative normal level. Level of serum alkaline phosphatase elevation was relatively less. All the deranged parameters normalized within seven days after operation.


Keywords


Cholelithiasis, Cholecystectomy. Clinicopathological study, Liver function tests, Preoperative status, Postoperative investigations.

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References


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