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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Liver Enzymes Be Tested For The Yellowness In Urine?

hi doctor I had Gall Bladder surgery through LAPROSCOPY 3 months ago, I am seeing Yellow urine in the morning and pale yellow for the rest of the day. Do I need to go for Liver egymes test ? and I feel some pain at the incision area neat the chest after 3 months also, please help me in this regard. Thanks in advance sujeevan t
Wed, 31 Dec 2014
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General Surgeon 's  Response
hi this is dr.subhadeep thanks for the opportunity to help you.

my management plan will be based on 2 steps,explaining about the probable diagnosis and appropriate management.

from your description i have 3 probable diagnosis:-

1) incomplete gall-bladder removal with a residual stone in the remnent of gall-bladder

2) possible cbd stone or slipped gall stone from gall-bladder to CBD leading to obstructive jaundice

3) stricture incomplete or partial leading to obstructive jaundice.

firstly you should keep a track on the daily intake of water.low intake of water can lead to yellow coloured urine and can be attributed to hepatobiliary pathology.

now coming to management:-

kindly do LFT and S.alkaline phosphatase and if it is elevated then we will proceed as per the situaton:

1) if it is due to remnent gall-bladder with retained stone then diagnostic laparoscopy with complete removalof remnent gall-bladder with retained stone should be done.

2)if it is due to CBD stone then ERCP stenting/open/laparoscopic cbd exploration wih stone removal and closure with t tube in situ to be done or open/lap choledochojejunostomy/roux-en-y hepaticojejunostomy to be done.

3)if it is due to stricture CBD then resection with choledocho/roux en y hepaticojejunostomy can be done either by open/lap procedure.

4) many gall bladder or cbd pathology is accompanied by an abnormal liver fatty liver or cirrhotic liver. if lft is deranged for that condition it can be supplemented with Liv 52 DS 2-0-1, it has to be taken empty stomach in morning.

- Also get your hepatitis panel checked.


Regards.
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Should Liver Enzymes Be Tested For The Yellowness In Urine?

hi this is dr.subhadeep thanks for the opportunity to help you. my management plan will be based on 2 steps,explaining about the probable diagnosis and appropriate management. from your description i have 3 probable diagnosis:- 1) incomplete gall-bladder removal with a residual stone in the remnent of gall-bladder 2) possible cbd stone or slipped gall stone from gall-bladder to CBD leading to obstructive jaundice 3) stricture incomplete or partial leading to obstructive jaundice. firstly you should keep a track on the daily intake of water.low intake of water can lead to yellow coloured urine and can be attributed to hepatobiliary pathology. now coming to management:- kindly do LFT and S.alkaline phosphatase and if it is elevated then we will proceed as per the situaton: 1) if it is due to remnent gall-bladder with retained stone then diagnostic laparoscopy with complete removalof remnent gall-bladder with retained stone should be done. 2)if it is due to CBD stone then ERCP stenting/open/laparoscopic cbd exploration wih stone removal and closure with t tube in situ to be done or open/lap choledochojejunostomy/roux-en-y hepaticojejunostomy to be done. 3)if it is due to stricture CBD then resection with choledocho/roux en y hepaticojejunostomy can be done either by open/lap procedure. 4) many gall bladder or cbd pathology is accompanied by an abnormal liver fatty liver or cirrhotic liver. if lft is deranged for that condition it can be supplemented with Liv 52 DS 2-0-1, it has to be taken empty stomach in morning. - Also get your hepatitis panel checked. Regards.