Liver enzyme alterations after laparoscopic cholecystectomy
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H.Erhan Güven, Süleyman Oral
3rd General Surgery Department, Ankara Oncology Research and Training
Hospital, Demetevler-Ankara, Turkey
Abstract
Aims. We aimed to investigate the alterations
in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase
(AST), gamma-glutamyl-transferase (GGT), alkaline phosphatase
(ALP) and lactate dehydrogenase (LDH) in patients who had undergone
laparoscopic cholecystectomy (LC) and compare these changes with
those occurring after open cholecystectomy (OC).
Methods. Of 267 patients who underwent LC between
January 2003 and December 2005, 86 patients without complications
were eligible for study. Twenty-six patients who underwent OC
during the same interval were also enrolled in the study as a
control group. Blood samples were taken preoperatively and 24
hours after operation for biochemical tests.
Results. Statistical analyses revealed significant
increases in AST, ALT, GGT and LDH levels in the LC group postoperatively.
Compared with the OC group, the differences between elevations
of enzyme levels were also significant for LC group.
Conclusion. We conclude that these enzyme elevations
could mostly be attributed to the negative effects of the pneumoperitoneum
on the hepatic blood flow. Although these changes do not seem
to be clinically important, care should be taken before deciding
to perform LC in patients with hepatic insufficiency.
Key words
Laparoscopic cholecystectomy - pneumoperitoneum - liver function
tests
