Title: A Prospective Study of Alteration in Liver Function Test after Laparoscopic Surgeries
Authors: Dr Krushnakumar G Virda, Dr Amul Bhedi
DOI: http://dx.doi.org/10.18535/jmscr/v4i9.20
Background: Laparoscopy is gaining wide popularity among surgeons in India. There have been no studies in our setting to evaluate the potential deleterious effects of laparoscopic surgery on hepatic function. This study is intended to assess the prevalence, and clinical significance of unexplained disturbances in liver enzymes following laparoscopic surgeries. Aim and Objectives: To evaluate the Alteration of Liver Function test in patients after Laparoscopic surgeries. And to Compare the Alteration of Liver Function test in Laparoscopic Surgeries with Open Surgeries Methods: Study conducted with total 60 patients selected by convenient sampling method from those who underwent laparoscopic and open surgery in Medical College Baroda and Sir Sayajirao General Hospital, Vadodara in the period from January 2015 to November 2015. levels of Aspartate Aminotransferase (AST or SGOT), Alanine Aminotransferase (ALT or SGPT), Serum bilirubin and Serum Alkaline Phosphatase were measured preoperatively once and then postoperatively on Day 1, Day 2 and Day 7. Results: Total 60 patients were studied. Mean difference in liver function test of Laparoscopic group was found between preoperative and postoperative day 1, No significant difference was found on postoperative day 2 and postoperative day 7. Mean difference [Elevation] shown as follow in preoperative and postoperative day 1 was Serum bilirubin: 0.85 mg/dL to 1.08 mg/dL, SGPT/ALT : 33.7 U/L to 50.96 U/L, SGOT/AST : 33.23 U/L to 50.66 U/L and Alkaline Phosphatase : 70.63 IU/L to 119.8 IU/L. Mean difference in liver function test of Open group was found between preoperative and postoperative day 1, No significant difference was found on postoperative day 2 and postoperative day 7. Mean difference [Small Degree of Elevation] shown as follow in preoperative and postoperative day 1 [except Serum Bilirubin] was Serum bilirubin: 0.84 mg/dL to 0.82 mg/dL, SGPT/ALT: 33.67 U/L to 35.10 U/L, SGOT/AST: 32.46 U/L to 35.76 U/L and Alkaline Phosphatase: 70.50 IU/L to 77.23 IU/L. Conclusion: We observed that elevation in liver function test on postoperative day 1 came back to normal on postoperative day 7 in laparoscopic surgery group. And there was small degree of elevation but within normal range in liver function test in open surgery group which came back to normal on postoperative day 7. Keywords: Laparoscopic Cholecystectomy, Postoperative Liver Function test. 1. Andrei VE, Schein M et.al.“Liver enzymes are commonly elevated following laparoscopic cholecystectomy: is elevated intra-abdominal pressure the cause?” Dig Surg 1998;15(3):256-9. 2. Halvey A, Gold-Deutch R et. al. “Are elevated liver enzymes and bilirubin levels significant after laparoscopic cholecystectomy in the absence of bile duct injury?” Am Surg1995 Apr;221(4):433. 3. Tan M, Xu FF et. al. “Changes in the level of serum liver enzymes after laparoscopic surgery.” World J Gastroenterol 2003 Feb 15; 9(l;2):364-367 4. Morino M, Giraudo G “Alterations in hepatic function during laparoscopic surgery. An experimental clinical study.” Surg Endosc 1998. 5. Saber AA, Laraja RD et.al. “Changes in liver function tests after laparoscopic cholecystectomy: not so rare, not always ominous.” Am Surg 2000 Jul;66(7) 699-702Jul;12(7):968-721. 6. H.Erhan Güven, Süleyman Oral; “Liver Enzyme Alterations after Laparoscopic Cholecystectomy”; J Gastrointestin Liver Dis December 2007 Vol.16 No 4, 391-394. 7. Ahmad NZ “Routine Testing of Liver Function Before and After Elective Laparoscopic Cholecystectomy”. JSLS (2011) Volume 15:65–69. 8. G Marakis, T Pavlidis, K Ballas, S Rafailidis, K Psarras, N Symeonidis, A Triantafyllou, A Sakantamis. “Alterations In Liver Function Tests Following Laparoscopic Cholecystectomy. “ The Internet Journal of Surgery. 2005 Volume 8 Number 13.Abstract
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