Impact of ERCP on Cholestatic Liver Enzymes in Patients with Obstructive Jaundice at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun, Nigeria

Abstract

Background: Obstructive jaundice is a common hepatobiliary disorder characterized by impaired bile flow and cholestasis, leading to significant morbidity if not promptly treated. Gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) are key cholestatic liver enzymes widely used in the diagnosis and monitoring of biliary obstruction. Aim: The present study evaluates GGT and ALP and activities in elderly patients with obstructive jaundice following ERCP at Obafemi Awolowo University Teaching Hospitals, Ile-Ife, Nigeria. Methods: A total of 100 elderly men and women, aged 60 years and above, diagnosed of extrahepatic biliary obstruction, preparing for ERCP at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria, were recruited for the study. Blood specimen was drawn from the subjects 48 hours before ERCP and one week after ERCP. The blood samples collected were determined for serum GGT and ALP activities using colorimetric methods. Statistical package for the social science, version 26.0 was used to obtain the results in mean ± SD. Paired t test was used to determine difference between means at a significant level of 0.05. Results: The mean result of ALP activity was 572.3 ± 263.3 IU/L and GGT was 505.9 ± 236.6 IU/L at 48 hours before ECRP. While the result of mean ALP activity was 295.2 ± 158.1 IU/L, and GGT activity was 258.0 ± 124.9 IU/L, after one week of ECRP procedure. The paired t test comparisons of the enzymes activities, before and after ECRP procedure, showed significant decrease in ALP and GGT activities after ERCP procedure (P<0.05). Conclusion: ERCP resulted in rapid and substantial declines in GGT and ALP activities among the elderly patients with obstructive jaundice. These findings highlight the usefulness of GGT and ALP as reliable biomarkers for assessing the resolution of biliary obstruction and monitoring treatment response.