AGA technical review on the evaluation of liver chemistry tests.

By R. Green, S. Flamm. Gastroenterology, 2002

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Liver enzyme alteration: a guide for clinicians (2005, background): “In healthy people, conjugated bilirubin is virtually absent from serum mainly because of the rapid process of bile secretion.(1) Levels increase when the liver has lost at least half of its excretory capacity.”
An Endocrine Society Clinical Practice Guideline Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: (2010, background): “Patients with marked increases in liver function tests (generally considered at two to three times the upper limit of normal) should be considered for additional testing by hepatobiliary ultrasonography or computed tomography, and a hepatitis screen if this was not done before surgery (165).”