What are the expected liver function test abnormalities in gallstone disease?

In gallstone disease, particularly when stones obstruct the bile ducts, the liver function tests typically show abnormalities that reflect cholestasis, or bile flow obstruction. This condition leads to an increase in alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) levels. Both enzymes are indicators of cholestatic liver disease.

An increase in ALP occurs because this enzyme is present in various tissues, including the bile ducts, so when there is an obstruction, the levels rise as the bile backs up. GGT often rises in conjunction with ALP and is considered a more specific marker for liver disease when elevated.

In gallstone disease, it is common to see normal levels of unconjugated bilirubin since it primarily reflects hemolysis or issues with conjugation, which are not directly related to gallstone disease. Therefore, while unconjugated bilirubin levels remain stable, the conjunction of increased ALP and GGT is a hallmark finding in this context, confirming that the bile duct obstruction is the main issue at play.

This aligns with the selection that indicates raised ALP and GGT with normal unconjugated bilirubin, identifying the typical liver function abnormalities expected in gallstone disease.