Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
2 results
Search Results
Item Presence of fatty liver disease leads to unusual rise of liver enzymes in patients with common bile duct colic(Korean Association of Hepato-Biliary-Pancreatic Surgery, 2021) Uragoda, B.; Ediriweera, D.; Paranahewa, L.; Ekanayake, C.; Tillakarathna, S.; Siriwardana, R.INTRODUCTION: This study compares liver enzymes, inflammatory markers and bilirubin levels in patients with and without fatty liver disease (FLD) presenting with common bile duct (CBD) obstruction. METHODS: CBD colic was diagnosed based on clinical, radiological and biochemical criterion. Presence of FLD was diagnosed by ultra sound scan and the macroscopic appearance of liver during surgery. Liver enzymes, inflammatory markers and bilirubin levels were prospectively assessed and compared between the two groups. RESULTS: Out of 42, there were 22 (52.3%) patients with FLD. Median body mass index was 26.9 (24.1–30.8) in fatty liver group compared to 25.7 (23.5–26.2) in others. Individuals with FLD showed high aspartate transaminase (558.5 vs. 247.0, p = 0.005), alanine trasaminase (467 vs. 228.5, p = 0.005) and bilirubin (3.8 vs. 2.2, p = 0.015) levels compared to those without FLD. According to multiple linear regression models, high AST and ALT levels showed significant associations with FLD after adjusting for age, gender, body mass index, amylase and C reactive protein levels. The median enzyme level at two weeks did not show a difference among patients with and without FLD. CONCLUSIONS:Presence of FLD causes unusual rise of AST and ALT levels in patients with CBD stones. This rise is transient.Item Idiopathic pancreatitis: is it a consequence of an altering spectrum of bile nucleation time?(BMJ Publishing, 2009) Abeysuriya, V.; Deen, K.I.; Navarathne, N.M.M; Kumarage, S.K.INTRODUCTION: The pathogenesis of idiopathic pancreatitis (IP) remains poorly understood. Our hypothesis is that IP is a sequel of the microcrystallisation of hepatic bile. AIMS AND METHODS: A prospective case–control study compared 55 patients (symptomatic cholelithiasis, 30: 14 men, 16 women, median age 36 years, body mass index (BMI) 25.1 ¡ 0.33 kg/m2 ; gallstone pancreatitis, nine: six women, three men, median age 35 years, BMI 24.86 ¡ 0.23 kg/m2 ; and idiopathic pancreatitis, 16: seven women, nine men, median age 34 years, BMI 23.34 ¡ 0.2 kg/m2 ) with 30 controls (15 men, 15 women, median age 38 years, BMI 24.5 ¡ 0.23 kg/m2 , undergoing laparotomy and who had normal gallbladder and no demonstrable stones on ultrasonography). Ultrafiltered bile from the common hepatic duct in patients and controls was anaerobically incubated and examined by polarised light microscopy, for nucleation time (NT). Ethical approval was obtained. RESULTS: Patients were similar to controls. Mean NT in all groups of patients was significantly shorter than controls (established gallstones cumulative mean NT, 1.73 ¡ 0.2 vs controls, 12.74 ¡ 0.4 days vs, p = 0.001, t test and IP patients mean NT, 3.1 ¡ 0.24 days vs controls, 12.74 ¡ 0.4 days, p = 0.001, t test). However, NT in those with IP was significantly longer compared with those with established gallstones (mean NT in IP, 3.1 ¡ 0.24 SEM days, vs cumulative mean in patients with established symptomatic gallstones, 1.73 ¡ 0.2 days, p = 0.002, t test). CONCLUSION: NT in bile in patients with IP is abnormal and is intermediate in NT of lithogenic and non-lithogenic bile.