What Causes Elevated Liver Enzyme Levels After Surgery To Cure Pancreatic Cancer?

Posted on Mon, 19 Mar 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 19 Mar 2018 Answered on

Tue, 2 May 2023 Last reviewed on

Question : At end of January I had major stage 3 pancreatic cancer surgery. I had my pancreas, spleen and stomach removed. 12 hour operation at the Mayo Clinic. I just had lab work and my liver numbers are all elevated. My ALT is 91, my AST is 62 and my alkaline phosphatase is 433. My bilirubin is .4. Should I be concerned regarding the liver.

Answered by Dr. Dr. Esmeralda Sera (1 hour later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Due to the tendency of pancreatic cancer to metastasize to the liver we have to be sure that you have not any liver damage regarding your laboratory tests results.

You should have further tests like abdominal CT scanner and tumor biomarkers CA 19,9 if you had not recently.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Esmeralda Sera (16 minutes later)

I had my last ct scan about 3 weeks ago. My surgeons made it very clear that I am cancer free and the operation has provided clean margins. Could the cancer spread. that fast.

Answered by Dr. Dr. Esmeralda Sera (12 minutes later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Then you should not be concerned if your CT scan was normal.

I will suggest you repeat the exams 2 weeks later and to have an abdominal ultrasound to check the function of the biliary tract.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Esmeralda Sera (15 hours later)

What could cause my alkaline phosphatase to go to 433. I have been taking tylenol and because of surgery could have bone loss.

Answered by Dr. Dr. Esmeralda Sera (1 hour later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Elevated alkaline phosphatase is most commonly caused by liver or biliary tract disorders or bone disorders.

The examinations required above will help to understand the high level of ALP.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Esmeralda Sera (1 hour later)

Dr Sera, I don't understand, if my biliruben is normal, how could the biliary tract have a disorder?

Answered by Dr. Dr. Esmeralda Sera (15 hours later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Would you like to please to download the attachment of your exams.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Esmeralda Sera (34 hours later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Dr. Esmeralda Sera (17 hours later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Bilirubin normal values are different in different laboratories.

If they are normal in your case and seeing the images sent then the possibility of bilirubin tract obstruction is small.

In any case, you should repeat the laboratory tests.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Esmeralda Sera (57 minutes later)

Dr Sera, you did not comment on the CTScan. Bilirubin at .4 is normal in all labs. Please comment on the CT scan.

Answered by Dr. Dr. Esmeralda Sera (23 hours later)

Brief Answer:
Pancreatic cancer.

Detailed Answer:

Hi,

Your CAT scan is without signs of malignancy.

Hope I have answered your query.

Regards,
Dr. Esmeralda Sera, Oncologist

Above answer was peer-reviewed by : Dr. Yogesh D