Comparison of pre-operative and post-operative liver function tests in patients undergoing laparoscopic cholecystectomy at different intra-peritoneal pressures

Zahida Akhter; Naveed Nabi; Showkat M. Kakroo; Sharik Mehraj

doi:10.18203/2320-6012.ijrms20230170

Authors

Zahida Akhter Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences Medical College and Hospital, Srinagar, Jammu and Kashmir, India
Naveed Nabi Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences Medical College and Hospital, Srinagar, Jammu and Kashmir, India https://orcid.org/0000-0003-0712-8640
Showkat M. Kakroo Jammu and Kashmir Health Services, Jammu and Kashmir, India
Sharik Mehraj Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences Medical College and Hospital, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230170

Keywords:

Hepatic dysfunction, Laparoscopic cholecystectomy, Pneumoperitoneum, Safe pressures

Abstract

Background: Establishing pneumoperitoneum is a pre-requisite for any laparoscopic procedure. However, its adverse effects are not uncommon. Increased intra-peritoneal pressure during laparoscopic cholecystectomy is expected to alter the liver function test (LFT) in immediate post-operative period, which may raise concerns in surgeons’ mind regarding integrity of biliary tract. The aim of our study was to compare the post-operative LFT with pre-operative values in patients undergoing laparoscopic cholecystectomy at different pneumoperitoneal pressures and to assess its clinical significance.

Methods: It was a prospective observational study in which the enrolled patients were divided into 2 groups. Group 1 patients underwent laparoscopic cholecystectomy at 12 mm Hg pressure and group 2 underwent the surgery at 15 mmHg pressure. Pre-operative LFT was compared with post-operative LFT done 24 hours and 2 weeks after surgery.

Results: Among 73 included patients, 41 constituted group 1 and 32 were included in group 2. Statistically significant difference was observed in hepatic transaminases between pre-operative and post-operative (1^st POD) values. Mean AST in group 1: 34.7 versus 51.4 U/l; in group 2, the values were 35.1 versus 50.9 U/l respectively. Mean ALT in group 1: 36.3 versus 50.1 U/l; in group 2, values were 32.9 versus 45.6 U/l respectively. However, the enzymes normalized in all patients in 2 weeks without any adverse clinical outcome.

Conclusions: Early post-operative transient elevation of hepatic transaminases after laparoscopic cholecystectomy is not associated with any adverse clinical outcome.

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