Laboratory Studies

Laboratory studies are an option for the investigation and management of gall stone disease.

These are of less use than in other abdominal conditions. In a patient with simple biliary colic blood tests are likely to be normal. Deranged liver function tests suggests that the patient may have developed more complicated gall bladder disease.

Full blood count

Forty percent of patients with acute cholecystitis may have a raised white cell count. This is non-specific and will often be raised in other causes of abdominal pain.

Learning Bite

In uncomplicated gall stone disease all bloods may well be normal [10].

Urea and electrolytes and liver function tests

• Serum alkaline phosphatase may be raised and is a marker for biliary tract obstruction. It has isoenzymes in liver, bone, placenta, small bowel and white cells so is not specific for biliary tract obstruction. It is also not a sensitive test as it may not be immediately raised in episodes of acute obstruction, since its elevation represents enzyme induction, which takes time to develop
• Serum alanine aminotransferase, white cell count and bilirubin may all also be normal [5]
• Serum amylase should be checked to exclude acute pancreatitis (serum lipase may be a better predictor of clinical acute pancreatitis) [10]
• Urea and electrolytes are likely to be normal in uncomplicated gall bladder disease

Learning Bite

All bloods may be normal in uncomplicated gall bladder disease.