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Hello, I Have An Active Social And Business/social Life, And

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Posted on Tue, 29 Oct 2019
Question: Brief Answer:
Elevation more then three times the maximum limit is significant only.

Detailed Answer:
Hello and thanks for choosing "Ask a Doctor" service for your query,
Have gone through your query in details,
Coming back directly to your question elevation in liver enzymes is significant only when they are elevated three times above the maximum normal limit.
What i can see is just a mild derangement.
So no this is not going to effect your knee surgery or any other surgery sir.
At the most doctor would ask you to go for a abdominal ultrasound to see if its fatty or not and bleeding time and clotting time test(as liver effects them..P.S-AT THE MOST).
AS of now you are clear for surgery.
Hope i was helpful,
Follow ups are welcome,
Do rate the answer.
Thank you!

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Follow up: Dr. Ramesh Kumar (0 minute later)
Hello, I have an active social and business/social life, and tend to drink more than I should... I make sure I get blood tests at least once a year, sometimes twice, to make sure I'm not causing any significant liver damage. I've actually cut back quite a bit, but at the same time, until recently,for about 6-7 months, I've been taking 2400 mg a day of Ibuprofen. Last blood test results show elevated levels of AST 62, ALT 52, and GGT 114. My question is this: I am in need of 2 surgical procedures: removing a stricture in my penis, and early next year, a knee replacement with a spinal anesthesia. Will any of the above blood levels be an issue with pre-op clearance for surgery?
doctor
Answered by Dr. Ramesh Kumar (7 minutes later)
Brief Answer:
Some surgeons are over skeptical.
As you were in USA, I wrote at the most if it was Europe you were fit for operation.

Detailed Answer:
Hi again,
If the surgeon is over skeptical.
So at the most means(for HIS/HER personal satisfaction but yes bleeding and clotting time would be done and are usually done in replacement surgeries.)
In your reports you could see that cholesterol too is elevated but that does not mean that a doctor would wait for two months to bring cholesterol levels to normal before performing a cardiac or any other surgery. One cant bring hundreds of parameters to normal at a time.
Your mildly deranged enzyme profile has nothing to do with your surgery.
Hope i was clear and easy to understand,
Feel free to follow back.


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (11 minutes later)
Thank you Doctor..

Regarding "At the most doctor would ask you to go for a abdominal ultrasound to see if its fatty or not and bleeding time and clotting time test(as liver effects them..P.S-AT THE MOST).",,,,'

What do you mean P.S.-AT THE MOST mean? Can you please elaborate.

Thank you..
doctor
Answered by Dr. Ramesh Kumar (11 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Not at all sir,
You must have heard about open cardiac surgery.Most of the patients have grossly deranged liver kidney and heart function as well as other tests while surgery is done.
Secondly yours is a spinal anesthesia even if surgeon choses to give general anesthesia mildly deranged parameters have no significance sir.
You are on high dose of ibuprofen and thats why LFT is mildly deranged.
As said earlier not at all a issue.
Thanks
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (15 minutes later)
Thank you doctor...

A clarification question: My concern was use of anesthesia in surgery with the liver blood levels being what they are... would any doctor have that concern? Again, the penis stricture removal would be not a full anesthesia, and the knee is being done with a spinal...
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Follow up: Dr. Ramesh Kumar (4 days later)
Hello Doctor; Can you please comment on the GGT level of 114 both in general and in terms of anesthesia for upcoming stricture and knee replacement surgeries. Thank you.
doctor
Answered by Dr. Ramesh Kumar (14 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Hello
Spinal anesthesia is given along the spine in thoracic lumbar region. The anesthetic used is not there in blood so blood levels of any enzyme has no relation with it.
Gamaglutamyl transferase is a enzyme secreted by cells of liver. Usually the concentration is highest in liver cells but is highly non specific and concentration could be high in Heart kidney pancreas and many other diseases.

They are just baseline tests.Very less sensitive and specific.
Hope I was helpful,
Thank you

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar (4 hours later)
Thank you.

The GGT number (114) is higher than what is considered the norm. How far out of the range is it, and how concerning to you as a doctor is it?

Thank you...
doctor
Answered by Dr. Ramesh Kumar (14 minutes later)
Brief Answer:
Follow up answer.

Detailed Answer:
Hello again dear,
Its definitely on higher side but again GGT is less sensitive test and can be elevated in pancreas liver cardiac and bone related issues.
An ultrasound liver can be done to be sure.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (2 hours later)
I may or not want to do an ultrasound, but would a urologist doing surgery to remove a penis stricture, or a doctor doing a knee replacement typically REQUIRE a sonogram before doing the procedure if they notice an elevated GGT level? I wouldn't want the surgery to be delayed because of that. Or would it just not be relevant to either procedure?
doctor
Answered by Dr. Ramesh Kumar (24 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
All your surgeon needs is anaesthesia(which has nothing to do with your blood GGT levels).
GGT is just a basic test and as told earlier can be increased due to multiple cause.
Every surgery is performed in mainly patients with some level of derangement in any parameter.
All parameters could never be normal in every case.
Don't worry this won't delay your surgery.
Thanks
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2906 Questions

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Hello, I Have An Active Social And Business/social Life, And

Hello, I have an active social and business/social life, and tend to drink more than I should... I make sure I get blood tests at least once a year, sometimes twice, to make sure I'm not causing any significant liver damage. I've actually cut back quite a bit, but at the same time, until recently,for about 6-7 months, I've been taking 2400 mg a day of Ibuprofen. Last blood test results show elevated levels of AST 62, ALT 52, and GGT 114. My question is this: I am in need of 2 surgical procedures: removing a stricture in my penis, and early next year, a knee replacement with a spinal anesthesia. Will any of the above blood levels be an issue with pre-op clearance for surgery?