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PTU-283 Usefulness of short-term post-operative lft monitoring after laparoscopic common bile duct exploration
  1. CC Wewelwala,
  2. P Cashin,
  3. D Croagh,
  4. G Jones
  1. Upper GI Surgery, Monash Medical Centre, Clayton, Australia

Abstract

Introduction This study examines the usefulness of postoperative LFT monitoring in diagnosing incomplete clearance of bile ducts after laparoscopic common bile duct exploration (LCBDE) performed during laparoscopic cholecystectomy (LC).

Method Data on all patients who had LCBDE over a period of three years were collected retrospectively. Patients who had unsuccessful LCBDE were considered for the test group and remaining patients were considered for the control group. Pre-operative, 12–24 h post-operative and 24–48 h post-operative alkaline phosphotase (ALP), gamma-glutamyl transferase (GGT), alanine transaminase (ALT) and bilirubin levels were recorded.

Results 20 patients in the test group and 52 patients in the control group were identified. 12–24 h postoperative blood tests compared to pre-operative blood tests revealed worsening or no improvements of LFTs in 10 of 10 in test group and 19 of 52 in control group (p = 0.30). After excluding patients who had intervention within 24 h, 24–48 h postoperative blood tests compared to 12–24 h postoperative blood tests revealed worsening or no improvements of LFTs in 7 of 16 in test group and 11 of 37 in control group (p = 0.322). 10 patients with a normal final intra-operative cholangiogram free of filling defects needed re-intervention due to retained choledocholithiasis subsequently. 6 of these 10 patients (60%) were discharged home on second post-operative day after observing improved LFTs but re-admitted for subsequent intervention.

Conclusion There is NO difference in post-operative LFT patterns between patients who had successful LCBDE and unsuccessful LCBDE. Therefore post-operative LFT monitoring is not reliable.

Disclosure of interest None Declared.

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