The Evaluation of Liver Function Before and After Relief of Biliary Obstruction

Objective To exploe the changes of liver function markers after relief of biliary obstruction in patients with benign or malignant jaundice.Methods 24 patients with cholangiolithiasis underwent endoscopic sphincterotomy(EST) and endoscopic nosabiliary drainage(ENBD).20 patients with malignant obstructive jaundice underwent percutaneous transhepatic cholangiographic drainage(PTCD) and posting of biliary metallic stents.Alanine transaminase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALT),glutamyltransferaseand(GGT),total bilirubin(TBIL),idirect bilirubin(DBIL) and total bile acid (TBA) were measured just before and 3rd,7th days after releasing from biliary obstruction. Results (1)The jaundice of benign or malignant wer decreased when obstruction were released.To following,all of the liver function markers after relief of biliary obstruction decreased,the levels of TBIL of benign and malignant jaundice decreased by 63% and 33% on 7th days after relief of obstruction,respectively.(2)Compared to before relief of biliary obstuction,ENBD decreased significantly the levels of almost of liver function markers(AST,AST,TBA,TBIL and DBIL) on 3rd and 7th days after relief of biliary obstruction(P0.05).The level of ALT,AST and TBA were significantly decreased in PTCD groups,too(P0.05).However,the decrease of TBIL and DBIL weren’t significant in PTCD groups(P0.05).Conclusion With regard to benign obstructive jaundice,EST combined with ENBD can relieve obstruction and promote the recovery of liver function.PTCD combined with biliary tract stents is a effective method to relieve malignant biliary obstruction and promote decrease of the transaminase.Because of the changes of jaundice weren’t significant,there were others causes to participate in the jaundice,for instance cholestasis.TBA is a better sensitive market for biliary obstruction.