| Summary: | Background : In daily practice, it is difficult to
differentiate between cholelithiasis and choledocholithiasis
patients by clinical symptoms. Even though obstructive
jaundice usually happen in choledocholithiasis, but it can
also being absence. This problem can lead to underdiagnosis
and cause the stone to be remain in the bile duct even after
operation. The biochemical testing such as bilirubin,
alkaline phosphatase and gamma glutamyl transferase can
indicate biliary obstruction.
Aim : The aim is to evaluate the difference in biochemical
marker which are bilirubin, alkaline phosphatase and gamma
glutamyl transferase at different gallstone locations in
cholelithiasis and choledocholithiasis patients.
Method : 88 patients from surgery department are selected for
this research. The subjects are divided into two groups which
are patients with choledocholithiasis (n=11) and
cholelithiasis (n=77). For total bilirubin, 75 cholelithiasis
and 11 choledocholithiasis are selected. While 28
cholelithiasis and 7 choledocholithiasis patients for
difference in alkaline phosphatase and 18 cholelithiasis and
7 choledocholithiasis patients for difference in Gamma
Glutamyl Transferase. The liver marker level were taken
maximum one week before the operation.
Results : Significant different was found in Bilirubin and
ALP P < 0.05 . Overall, the median shows that the level of
Bilirubin and ALP is higher in choledocholithiasis if compared
with cholelithiasis patients. While no significant different
in Gamma Glutamyl Transferase was found P > 0.05. Eventhough
overall median results shows that the level of GGT in
choledocholithiasis is higher than in cholelithiasis but some
low ranks and some high ranks will occur in each group, that
is the ranks will be distributed across the two group which
are cholelithiasis and choledocholithiasis more or less
evenly.
Conclusion : In a conclusion, only bilirubin and alkaline
phosphatase level have a significant difference in different
gallstone location.
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