Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis

Abstract

Background: Extrahepatic cholestasis that is caused by benign and malignant diseases has been reported to increase liver stiffness (LS), as measured by transient elastography (TE). Objectives: The aim of this study was to evaluate LS in patients with extrahepatic cholestasis due to choledocholithiasis before and after endoscopic sphincterotomy and stone removal.Patients and Methods: LS was measured by TE (Fibroscan) in patients with extrahepatic cholestasis that was caused by choledocholithiasis before and 1 month after endoscopic sphincterotomy and successful stone removal.Results: We studied 12 patients (7 females, 5 males), aged 36 to 76 years (mean age 57.1 ± 11.6 years), with extrahepatic cholestasis that was caused by choledocholithiasis. LS was increased in all patients (range: 6.2-18.4 kPa; mean: 8.9 ± 3.5 kPa) before endoscopic therapy. Successful biliary drainage was effected by sphincterotomy and stone removal in all patients, which led to a significant decline in LS to 3.9-8.1 kPa (Mean: 5.6 ± 1.2 kPa; p < 0.001) within a mean observation time of 29 days. The decrease in LS values correlated significantly with a decline in serum total bilirubin levels (r = 0.691; p < 0.0001). Conclusions: Extrahepatic cholestasis due to choledocholithiasis increases LS and should be excluded before assesing liver fibrosis by transient elastography.

Implication for health policy/practice/research/medical education:In this interesting article, you will find out a new method for diagnosis of liver stiffness. Reading this article is recommended to radiologists involved in hepatology.

Please cite this paper as: Trifan A, Sfarti C, Cojocariu C, Dimache M, Cretu M, Hutanasu C, et al. Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis. Hepat Mon. 2011;11(5):372-375.

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