The Predictive Value of Gamma-Glutamyl Transferase on Jaundice Clearance in Biliary Atresia: An Evidence-Based Case Report and Meta-Analysis

Authors

  • Megan Quinka D Toding Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Awliya Syamsul Munir Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Mutiara Ramadhanty Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Lowilius Wiyono Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.58427/apghn.3.3.2024.20-31

Keywords:

biliary atresia, gamma-glutamyl transferase, jaundice clearance, kasai surgery, prognosis

Abstract

Background: Biliary atresia (BA) is a neonatal condition characterized by the obstruction of extrahepatic bile ducts.

Case: A 2-year-old female with BA underwent a Kasai procedure at 3 months of age. Despite the surgery, she developed persistent jaundice and abdominal enlargement. Preoperative laboratory findings revealed elevated liver enzymes, GGT, and bilirubin levels. This case raises the clinical question of whether preoperative GGT levels can predict JC after the Kasai procedure, in addition to its role in diagnosis.

Methods: A systematic literature search was performed on 4 databases (PubMed, Scopus, Cochrane, and Proquest) by using relevant keywords and identified seven high quality studies.

Results: Five studies found higher GGT levels in patients who achieved JC following Kasai surgery, compared to those with unsuccessful jaundice clearance (JUC). However, two studies reported conflicting findings. A pooled analysis indicated a non-significant trend toward higher GGT levels in the JC group compared to the JUC group (WMD: 65.6, 95% CI: -58.6; 189.8).

Conclusion: Elevated preoperative GGT levels may be associated with improved JC in BA patients. However, further investigation to validate these findings, determine the optimal role of GGT in assessing prognosis, and later, guiding treatment decisions in BA patients.

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Published

2024-08-31

How to Cite

1.
The Predictive Value of Gamma-Glutamyl Transferase on Jaundice Clearance in Biliary Atresia: An Evidence-Based Case Report and Meta-Analysis. Arch Pediatr Gastr Hepatol Nutr [Internet]. 2024 Aug. 31 [cited 2024 Nov. 13];3(3):20-31. Available from: https://apghn.com/index.php/journal/article/view/70