Laboratory parameters of the 1st order – obligatory laboratory tests.
- Blood count incl. differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin [elevated cholestasis parameters, esp. gamma-GT and AP]Note: Repeated normal liver values initially and 24 h after pain onset make the presence of symptomatic choledocholithiasis highly unlikely.
- Cholesterol (HDL/LDL); triglycerides.
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification, etc.
- Concrement analysis
- Cholesterol pigment calcium stones (> 80%).
- Brown pigment stones (circa 10%) – in chronic bacterial infection.
- Black pigment stones (circa 10%) – in chronic hemolytic anemia (form of anemia caused by increased or premature decay of erythrocytes (hemolysis)).
- Hemoglobin electrophoresis, osmotic resistance of erythrocytes (red blood cells) – if hemolysis (decay of erythrocytes) is suspected.
- Parathyroid hormone – if hyperparathyroidism (parathyroid hyperfunction) is suspected.
