Abstract

COâ‚‚ pneumoperitoneum may be one of the primary causes of the alteration in blood liver enzyme levels. However, these findings suggest that laparoscopic surgery may not be the best option for treating cholelithiasis if the patient's preoperative liver function was very poor. Objective: To determine prevalence and clinical significance of unexplained liver enzyme changes following laparoscopic cholecystectomy. Methods: Prospective, observational study was conducted among 70 patients undergoing laparoscopic cholecystectomy. Laparoscopic cholecystectomy was done as per the standard operative procedure. The abdomen was inflated with carbon dioxide. Liver enzymes were measured before surgery, and post-operatively on day one, three and seven. Each patient was followed for seven days after surgery. Results: Females were 49 (70.0%) and males were 21 (30.0%). Mean age of the patients was 40.1+8.6 years. Carbon dioxide insufflation had dramatic effect on the liver enzymes. All the liver enzymes values increased significantly (P<0.05) on postoperative day one. But over the period of one week, the values decreased slowly and steadily and almost returned to the baseline levels. 37 (52.9%) patients had duration of COâ‚‚ Pneumoperitoneum < 70 minutes) and 33 (47.1%) had > 70 minutes. Duration of carbon dioxide pneumoperitoneum lasted 65 to 85 minutes, it was observed there was a significant change in liver function enzymes where duration lasted more than 70 minutes. Conclusion: Carbon dioxide insufflation had dramatic effect on liver enzymes. All liver enzymes values increased significantly (P<0.05) on postoperative day one. But over week, the values decreased slowly and steadily and almost returned to baseline levels

Description