The significance of isolated hyperbilirubinemia in detecting asymptomatic common bile duct stones in patients undergoing laparoscopic cholecystectomy.

Aim: The aim of this study was to evaluate the role of isolated hyperbilirubinemia in the detection of choledocholithiasis.

Methods: A retrospective cohort study focused on adult patients diagnosed with gallstone disease, and undergoing intra-operative cholangiogram for suspected choledocholithiasis. Those presenting with isolated hyperbilirubinemia were investigated for their risk of choledocholithiasis, and were compared with those with normal liver function tests.

Results: Out of the total 1274 patients undergoing intra-operative cholangiogram in the study period, only 18 exhibited isolated hyperbilirubinemia. Among these, four patients were found to have common bile duct (CBD) stones. This indicates that in approximately 22 % of patients, isolated hyperbilirubinemia may be associated with CBD stones. However, it is essential to note that the number of patients in the study with isolated hyperbilirubinemia was relatively small.

Conclusion: Although the incidence of isolated hyperbilirubinemia was limited in our study, the presence of CBD stones in some of these patients suggests a potential association. Isolated hyperbilirubinaemia should not be overlooked as a risk factor for CBD stones. Nonetheless, additional investigations with a larger sample size are needed to establish a more definitive understanding of the relationship between isolated hyperbilirubinemia and choledocholithiasis.