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Risk Factors for Markedly Elevated Aminotransferases in Patients with Common Bile Duct Stones
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J Shokri Shirvani    , P Akbari Shahabi , H Gholinia , C Behzad * |
| 1.Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, I.R.Iran. , catherinebehzad@yahoo.com |
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Abstract: (99 Views) |
Background and Objective: Elevated liver transaminases, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are helpful in the diagnosis of liver diseases and injuries. Marked elevation of these enzymes is most frequently observed in hepatocellular injury. In biliary tract disorders and cholestasis, aminotransferase levels typically do not rise significantly. An exception to this pattern is biliary obstruction resulting from stone passage through the common bile duct. However, limited data exist regarding the risk factors for significant aminotransferase elevation in common bile duct obstruction. The aim of this study was to investigate the risk factors for markedly elevated aminotransferases in patients with common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP).
Methods: In this cross-sectional study, clinical and paraclinical findings were evaluated in 322 patients with common bile duct stones who underwent ERCP at Rouhani Hospital in Babol. The patients were divided into two groups: a case group comprising individuals with ALT and/or AST levels ≥ 500 IU/L, and a control group comprising individuals with ALT and/or AST levels < 500 IU/L. The two groups were compared regarding sex, presence of pain, common bile duct diameter, and gallstone size.
Findings: Of the 322 patients evaluated, 131 were assigned to the case group (ALT/AST≥ 500 IU/L) and 191 to the control group (ALT/AST< 500 IU/L). The overall mean age of the patients was 62.02±13.46 years. The frequency of common bile duct stones in the case group was 38.7%. Significant differences were observed between the case and control groups with respect to younger age (52.22±21.71), female sex, presence of pain, smaller common bile duct diameter (9.72±6.10 mm), and smaller stone size (10.33±4.37 mm) (p<0.05). These factors were independently associated with enzyme elevation.
Conclusion: The results of this study demonstrated that risk factors including younger age, female sex, presence of pain, common bile duct diameter, and stone size may influence the elevation of liver enzymes. These findings may assist in improving the management of patients undergoing ERCP. |
Article number: e17 |
| Keywords: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Endoscopic Retrograde Cholangiopancreatography (ERCP), Common Bile Duct (CBD). |
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Full-Text [PDF 596 kb]
(31 Downloads)
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Type of Study: Cross Sectional |
Subject:
Internal (Digestive)
Received: 2025/06/16 | Accepted: 2025/07/1 | Published: 2026/06/6
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