Author : O. Hamad, Salah
Annals of the College of Medicine, Mosul,
2013, Volume 39, Issue 2, Pages 113-117
Background: Laparoscopic cholecystectomy (LC) has become the standard treatment of benign gallbladder diseases. However, it has been noticed that following LC, the serum level of certain liver enzyme rises markedly in patients who had preoperatively normal liver enzyme values.
Objectives: The study is aimed to evaluate the effect of pneumoperitoneum in LC on liver enzymes and serum bilirubin in comparison with open cholecystectomy (OC).
Patients and methods: A prospective case control study involved 74 patients treated by LC, and, 30 patients treated by OC as a control group, during the period from October 2010 to October 2011 at the Department of Surgery, Surgical Unit Number One, Al-Jumhori Teaching Hospital, Mosul, Iraq. Blood samples were taken 24 hours preoperatively and 24 hours after operation for biochemical tests.
Results: There were significant increases in serum bilirubin, Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and Lactate dehydrogenase (LDH) levels in LC group postoperatively when compared with the OC group, while there were no significant changes in serum alkaline phosphatase (ALP).
Conclusion: It has been concluded that, serum bilirubin and liver enzymes elevation could be attributed to the negative effects of the pneumoperitoneum on the hepatic blood flow. Although these changes seem to be of no clinical importance, care should be taken before deciding to perform LC in patients with hepatic insufficiency.
Keywords: Laparoscopic cholecystectomy, pneumoperitoneum, liver enzymes.