Routine testing of liver function after biliary-enteric anastomosis has noclinical relevance

Background/Aims: Patients who had a biliary-enteric anastomosis often have elevated liver function tests. The aim of this study was to investigate whe ther elevated Liver function tests are associated with recurrent episodes o f cholangitis. Methodology: Thirty-two patients, who received a biliary-enteric anatomosis for benign biliary disease were evaluated. Follow-up consisted of the pati ent's history, physical examination, determination of liver function tests, ultrasonography and hepatobiliary scintigraphy using 99(m)Tc-HIDA Results: Median duration of follow-up was 45 months (range: 1-192) and live r function tests were elevated in 22 patients (69%) at some time during fol low-up. Dilated intrahepatic ducts were found in 3 of 30 patients (10%), al l of whom had elevated liver function tests at follow-up. Delayed passage f rom the liver was observed using scintigraphy in 10 (31%) of the patients. Seven patients (22%) experienced one episode of cholangitis and none experi enced more than one episode. Multivariate analysis showed that male sex was an independent risk factor for elevated liver function tests (odds ratio: 10.9; P < 0.05). For cholangitis, no risk factors could be identified. Conclusions: It is concluded that elevated liver function tests are relativ ely common after a biliary-enteric anastomosis for benign biliary tract dis ease and are not predictive of the occurrence of cholangitis. We, therefore , recommend omitting routine laboratory screening for elevated liver functi on tests in the follow-up of a biliary-enteric anastomosis.