Liver Tests

Liver Tests (LTS), often called Liver Function Tests, are blood tests that monitor the health of the Liver and the Bile ducts. Along with one’s history and physical examination, the Liver Tests guide the healthcare provider to diagnose and manage Liver disease, if any.

These tests measure the levels of certain enzymes and proteins in the blood, how well the liver is performing its functions, and measure enzymes that liver cells release in response to damage or diseases.

• Bilirubin test (direct and indirect) to ascertain jaundice and its type
• Proteins and Albumin test
• Enzymes Alanine Aminotransferase – ALT (previously called SGPT)
• Aspartate Aminotransferase – AST (previously called SGOT)
• Alkaline Phosphatase (Elevated levels of the first 2 enzymes indicate liver cellular damage; and Elevated levels of the last 2 enzymes indicate obstruction in the bile flow)
• Gamma Glutamyl Transferase (GGT)
• Prothrombin time and INR (shows synthetic function of the liver)
• Viral serology for Hepatitis B and C, Cytomegalo Virus, Epstein Barr Virus and HIV
• Immunoglobulin Study
• Ferritin
• Alpha Fetoprotein
• Biopsy of Liver tissue

The doctor also does a complete physical examination and checks for the liver, spleen, free fluid in the abdomen, obesity, lymph nodes, anemia and jaundice. The medical history may include questions regarding drugs & alcohol intake, tattoos, unprotected sex, occupation, history of diabetes, high lipids in blood and family history.

It is a diagnostic procedure used to obtain a small amount of liver tissue, which is then examined under a microscope to determine what is causing the liver disease, as well as the degree of fibrosis (scarring) of the liver.

The use of video endoscopy has greatly facilitated the management of all patients with chronic liver disease. Upper endoscopy plays a pivotal role in the diagnosis and management of oesophageal and gastric varices. Endoscopic ultrasound is increasingly being used to detect varices and in the staging of gastrointestinal tumors.

Endoscopic retrograde cholangio pancreatography (ERCP) plays an important role in the diagnosis of recurrent pyogenic cholangitis. Endoscopic sphincterotomy is a useful form of treatment. Laparoscopy, with the aid of ultrasound and biopsy is helpful in staging chronic liver disease, identifying focal lesions, and diagnosing peritoneal disease.

Surgery for a liver transplant is challenging, and typically lasts 6 to 10 hours. During the operation, the surgeons will remove the injured or diseased liver and replace it with the donor liver, and place several tubes in the patient’s body to assist it in doing specific tasks throughout the procedure, and for a few days after it. The tubes include a catheter to remove urine from the bladder, intravenous lines to administer fluids and medications, a breathing tube, and other tubes to drain blood and fluid from the abdomen.