Comparison of postoperative hepatic function between laparoscopic and open cholecystectomy.
| Autor: | Hasukic S; Department of Surgery, University Clinical Center, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia-Herzegovina. shasukic@bih.net.ba, Kosuta D, Muminhodzic K |
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| Jazyk: | angličtina |
| Zdroj: | Medical principles and practice : international journal of the Kuwait University, Health Science Centre [Med Princ Pract] 2005 May-Jun; Vol. 14 (3), pp. 147-50. |
| DOI: | 10.1159/000084630 |
| Abstrakt: | Objective: In this prospective study, we evaluated the effects of pneumoperitoneum on hepatic function during laparoscopic (LC) and open cholecystectomy (OC). Subjects and Methods: One hundred patients who underwent LC (n = 50) or OC (n = 50) were included in the study. The groups were similar in age, sex, weight and height. Following liver function tests (total bilirubin; gamma-glutamyltransferase, GGT; alkaline phosphatase, ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) were obtained preoperatively and at 24 and 48 h postoperatively. Similar anesthesiologic protocol was used for both LC and OC. During LC, the intra-abdominal pressure was maintained within the conventional range of 12-14 mm Hg. Results: Total bilirubin, ALP, GGT and LDH levels remained unchanged from baseline in both groups without significant difference between them. A higher number of patients had increased values of ALT (26/50 vs. 5/50) and AST (23/50 vs. 6/50) in LC compared to OC group. Although the difference was statistically significant (p < 0.000 for ALT and p = 0.0004 for AST) the increased level decreased at 48 compared to 24 h. Conclusion: The results indicate that LC is associated with transient elevation of ALT and AST. The disturbances in the function of the liver after LC are self-limited and not associated with any morbidity in patients with a normal liver function. |
| Databáze: | MEDLINE |
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