Effect of Duration of Surgery on Liver Enzymes After Cholecystectomy: Safety or Duration

Abstract

Background: An elevation of serum liver enzymes after laparoscopic cholecystectomy (LC) occurs due to transient decrease in splanchnic blood flow. The changes are attributed to CO₂ gas inside the abdominal cavity for a prolonged period as compared to open surgeries.

Methods: This study was conducted in the Department of Surgery at M. M. Institute of Medical Sciences and Research, Mullana, Haryana, India. A total number of 300 patients diagnosed as cholelithiasis were included from January 2014 for a period of 2 years. These patients were randomly divided into three groups: LC was done in groups A and B (intraabdominal pressures of 10 and 14 mm Hg, respectively) and in group C, open cholecystectomy was performed. In all the patients, liver function tests (LFTs) were done pre- and postoperatively and the levels changed in LFTs were noted.

Results: In LC, changes were seen in serum bilirubin, aspartate transaminase (AST) and alanine transaminase (ALT) after 24 h of surgery. But there was not much difference observed between pre- and post-surgery in LFTs (P > 0.05). In LC, with low pressure (short and long duration), LFTs were changed to less extent than in high pressure (short). In prolonged surgery under high pressure, LFT significantly changed postoperatively (P < 0.05).

Conclusion: Duration of surgery has definitively impact on the liver enzymes but it does not remain for prolonged period. Not only the prolonged time but also pneumoperitoneum pressure affects liver enzymes in laparoscopic surgery especially in high pressure CO₂.




J Curr Surg. 2017;7(4):53-57
doi: https://doi.org/10.14740/jcs334w