Preoperative method of assessment of gallbladder lesion in acute cholecystitis

Abstract

Background. To date acute cholecystitis remains one of the most common urgent abdominal diseases in which postoperative complications and mortality are possible.The aim. To assess the correlation of gamma-glutamyltranspeptidase and alkaline phosphatase concentrations in blood plasma with the form of acute cholecystitis.Methods. A study of 105 patients with acute calculous cholecystitis, 35 – with chronic calculous cholecystitis (comparison group), who underwent laparoscopic cholecystectomy, was performed. At admission to the hospital, the activity of gammaglutamyltranspeptidase (GGTP) and alkaline phosphatase in blood plasma was determined by kinetic colorimetric method.Results. A direct correlation was revealed between the level of GGTP concentration and the severity of destruction in the gallbladder wall. With catarrhal cholecystitis, it was 340 ± 116.9 U/l (p < 0.05), with phlegmonous – 108.1 ± 29.5 U/l (p < 0.05), with gangrenous – 32.9 ± 7.5 U/l (p < 0.05). Along with this, a direct correlation was revealed between the concentration of alkaline phosphatase and the severity of destruction in the gallbladder wall. In catarrhal cholecystitis, the enzyme activity was 160.3 ± 34.2 U/l (p < 0.05), in phlegmonous – 129.9 ± 14.6 U/l (p < 0.05), in gangrenous – 57 ± 18.5 U/l (p < 0.05).Conclusion. Determination of the concentration of GGTP and alkaline phosphatase in combination with other diagnostic criteria makes it possible to determine the presence of destructive forms of acute cholecystitis with high specificity and sensitivity before surgery.

Keywords

• prognosis
• acute cholecystitis
• destructive cholecystitis
• cholelithiasis
• gamma-glutamyltranspeptidase
• alkaline phosphatase