Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis

Background: extrahepatic cholestasis that is caused by benign and malignant diseases has been reported to increase liver stiffness (ls), as measured by transient elastography (te).objectives: the aim of this study was to evaluate ls in patients with extrahepatic cholestasis due to choledocholithiasis before and after endoscopic sphincterotomy and stone removal. patients and methods: ls was measured by te (fibroscan) in patients with extrahepatic cholestasis that was caused by choledocholithiasis before and 1 month after endoscopic sphincterotomy and successful stone removal. results: we studied 12 patients (7 females, 5 males), aged 36 to 76 years (mean age 57.1 ± 11.6 years), with extrahepatic cholestasis that was caused by choledocholithiasis. ls was increased in all patients (range: 6.2–18.4 kpa; mean: 8.9 ± 3.5 kpa) before endoscopic therapy. successful biliary drainage was effected by sphincterotomy and stone removal in all patients, which led to a significant decline in ls to 3.9–8.1 kpa (mean: 5.6 ± 1.2 kpa; p < 0.001) within a mean observation time of 29 days. the decrease in ls values correlated significantly with a decline in serum total bilirubin levels (r = 0.691; p < 0.0001). conclusions: extrahepatic cholestasis due to choledocholithiasis increases ls and should be excluded before assesing liver fibrosis by transient elastography.