Study of Effect of Pneumoperitoneum on Liver Function Following Laparoscopic Cholecystectomy

1 Professor of Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, PUNE – 411018 Email: [email protected], Mobile No: 9561744365 2 Professor of Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, PUNE – 411018 Email: [email protected], Mobile No: 9822057750 3 Assistant Professor of Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, PUNE – 411018 Email: [email protected], Mobile No: 9673788109 4 Senior resident in General Surgery, Dr. D.Y. Patil Vidyapeeth, Pimpri, PUNE – 411018 Email: [email protected], Mobile No: 9623403149 Abstract This study was undertaken in 60 patients with the aim of assessing the presence and significance of disturbances in liver enzymes following laparoscopic cholecystectomy. The liver function parameters measured preoperatively and post operatively on day 1 and day 7 were Total bilirubin, Aspartate aminotransferase, Alanine aminotransferase and Alkaline phosphatase . Duration of pneumoperitoneum was noted in all cases. Observations and Results Serum bilirubin was elevated in the immediate post-operative period, which came back to near pre-op values within 1 week. Similarly, liver enzymes, Serum AST, ALT and Alkaline phosphatase levels were found to be significantly elevated in 48 hours postoperatively which returned to near pre-op values by 7 days postoperatively. This was more pronounced in those patients who had prolonged CO2 insufflation time. ConclusionThese transient changes might be attributed to hepatocellular dysfunction secondary to combination of CO2 pneumoperitoneum, diathermy on liver and general anaesthesia. The transient elevation of enzymes showed no apparent clinical implication in the patients. These result indicate that if the preoperative liver function was very poor, laparoscopic cholecystectomy might not be the optimal choice for treating cholelithiasis.