Title: Study of Effect of Pneumoperitoneum on Liver Function Following Laparoscopic Cholecystectomy
Authors: Dr Mahendra Bendre, Dr Shahaji Chavan, Dr Nilesh Sinha, Dr Nishith Reddy
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.152
Abstract
This study was undertaken in 60 patients with the aim of assessing the presence and significance of disturbances in liver enzymes following laparoscopic cholecystectomy. The liver function parameters measured preoperatively and post operatively on day 1 and day 7 were - Total bilirubin, Aspartate aminotransferase, Alanine aminotransferase and Alkaline phosphatase . Duration of pneumoperitoneum was noted in all cases.
Observations and Results - Serum bilirubin was elevated in the immediate post-operative period, which came back to near pre-op values within 1 week. Similarly, liver enzymes, Serum AST, ALT and Alkaline phosphatase levels were found to be significantly elevated in 48 hours postoperatively which returned to near pre-op values by 7 days postoperatively. This was more pronounced in those patients who had prolonged CO2 insufflation time.
Conclusion- These transient changes might be attributed to hepatocellular dysfunction secondary to combination of CO2 pneumoperitoneum, diathermy on liver and general anaesthesia. The transient elevation of enzymes showed no apparent clinical implication in the patients. These result indicate that if the pre-operative liver function was very poor, laparoscopic cholecystectomy might not be the optimal choice for treating cholelithiasis.
Keywords – Laparoscopic, Cholecystectomy, Pneumoperitoneum, Liver enzymes
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