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Elevated Liver Values after Whipple?
Hello! I had my Whipple surgery in June, 2024. Every three to four months I have had my control CT and bloodwork which have come back normal with the exception of my liver values being elevated.
I was wondering if this is common after Whipple? My Oncology Dr. is not concerned. Does anyone know why?
Thank you for the feedback! Much appreciated!
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Yes my liver enzymes ( all 3 AST, ASP and ALK) have been slightly above normal for two years now. I had my whipple in January 2023 and 12 rounds of folfirinox that ended July 2023. No one seems concerned. I have tried removing all drugs (gabapentin, nsaids and losartan) for 10 days before blood work but little change. I do not drink any alcohol. They did ultrasound of liver which was normal. I have CT every 5 months and all say normal liver. Now on my insistence the GI doc is doing some blood work to look for all kinds of other liver issues. She said ultimately they might have to biopsy which I probably will not do since my liver is the only thing that was not disturbed and I would rather leave it alone!
@leeboyes Thank you for the feedback! I pursued on this issue with the medical team on my elevated liver values ( AST / ACT / and Bilirubin) after my Whipple last year.
It appears it is not uncommon to have mild elevations in Alkaline Phosphatase due to the biliary anastomosis (simply because your bile duct was sewn into a new piece of intestine these labs are often elevated for years even after surgery).
It would be uncommon for surgery to affect my bilirubin though. Since my CT imaging is normal, they know there is no problem with your bile duct.
There is also a condition people have (Gilbert's disease), where the liver doesn't properly process bilirubin and this can lead to mild elevations in these labs. There is a blood test to verify this condition.
At this point in time, I totally feel like you do. Leave it alone unless unless absolutely necessary.
@carfbuch
I agree! Leave well enough alone. Glad to read that I’m not the only one experiencing fluctuation in liver enzymes. Might be something we have to deal with for years, post Whipple. At least my latest MRI was clear and no stricture at this time.