Title: Changes in serum bilirubin after laparoscopic cholecystectomy
Authors: Dr T.Lakshmi Nirupama, Dr Venkatesh N.S, Dr Srinath. S, Dr Chandana Krishna, Dr A. Krishna Girish, Dr Sharath Kumar.S, Dr Chandan G.B
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.139
Abstract
Introduction: Marked changes has been evoked in modern era in approach to surgical diseases by laparoscopic procedures. All Laparoscopic procedures are usually performed by creating pneumoperitoneum. The main advantage of laparoscopic procedures is lesser tissue trauma due to smaller incision. Apart from advantages in laparoscopic procedures; effects of pneumoperitoneum on the cardiovascular and respiratory system resulting in several pathophysiological changes in the patients have been reported. ‘Unexplained’ changes noted in postoperative liver function tests (LFT)and serum bilirubin in patients undergoing laparoscopic procedures have been stated recently. These changes are transient and could occur after laparoscopic procedures. One of the reasons for the changes in LFT and serum bilirubinmight be the CO2 pneumoperitoneum. Hence, the study is performed to correlate the changes in serum bilirubin pre-operative and post operative period.
Materials and Methods: It is a descriptive study in which serum bilirubin of 31 patients who had underwent laparoscopic cholecystectomy using CO2 to create pneumoperitoneum. Blood sampling were collected both preoperatively and post operatively on day 1 and day 3 for serum bilirubin along with routine investigations.
Results: There is significant rise in serum bilirubin on post op day 1 with p- value <0.0001. And eventual decrease of values to near pre operative on post op day 3.
Conclusion: In this study we conclude that there was a transient changes in serum Bilirubin on the POD-1 which reverted back to near normal to the pre-operative level by POD-3. There was no complication, no morbidity and no mortality.
Keywords: Laparoscopic procedures, serum bilirubin, CO2 pneumoperitoneum.
