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Changes in the level of serum liver enzymes after laparoscopic surgery

MinTan Feng-FengXu Jun-ShenPeng Dong-MingLi Liu-HuaChen Bao-JunLv Zhen-XianZhao ChenHuang Chao-XuZheng

关键词：血清学检查肝酶腹腔镜外科肝功能胆囊切除术

主要内容：AIM: The purpose of this study was to investigate the effect of laparoscopic surgery on liver function in humans and the possible mechanisms behind such effect.METHODS: Blood samples from 286 patients who underwent laparoscopic cholecystectomy (LC) and 40 patients who underwent open cholecystectomy (OC) were tested for liver function by measuring the level of serum alanine aminotrasferase (ALT) and aspartate aminotrasferase(AST) before and after the operations. The same tests were also applied to 18 laparoscopic colorectal cancer resection(LCR) patients and 23 open colorectal cancer resection (OCR)patients to determine whether CO2 pneumoperitoneum could alter the serum liver enzymes.RESULTS: The level of serum ALT and AST increased significantly during the first 48 hours post operations in beth LC and LCR patients. However, no significant change of the serum liver enzymes was detected in both OC and OCR patients. As a result, there was statistically significant difference in change of both ALT and AST levels between LC and OC patients and LCR and OCR patients, respectively.By the 7^th day post operation, the level of both enzymes returned to normal values in LC, OC and OCR patients except LCR patients whose enzymes remained at a higher level.CONCLUSION: Transient elevation of hepatic transaminases occurred after laparoscopic surgery. The major causative factor seemed to be the CO2 pneumoperitoneum. In most of the laparoscopic surgery patients, the transient elevation of serum liver enzymes showed no apparent clinical implications. However, if preoperative liver function was very poor, laparoscopic surgery may not be the best choice forthe treatment of patients with certain abdominal diseases.

《世界胃肠病学杂志：英文版》 2003,9(2).-364-367

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