腹腔镜和开腹结直肠癌手术术后肝功能的比较

Comparison of postoperative hepatic functions between laparoscopic and open colorectal surgery

目的探讨腹腔镜和传统开腹结直肠癌术后肝功能变化的差异性. 方法 2003年1～6月结直肠癌40例,腹腔镜组20例,传统手术开腹组20例,肝功能检查包括总胆红素(TBil)、白蛋白(Alb)、γ-谷氨酰转酞酶(γ-GT)、碱性磷酸酶(ALP)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT).以上各项分别在术前和术后1、24、48、72 h采血. 结果两组之间Alb和ALP均降低,而TBil和γ-GT无明显改变.两组术后ALT和AST较术前增加约3倍,并在72 h回到术前水平.两组无术后肝功能衰竭和死亡. 结论腹腔镜结直肠癌手术和传统开腹手术均导致肝脏转氨酶的短暂升高,腹腔镜手术对肝功能的影响与开腹手术相近.

Objective To investigate the difference on postoperative hepatic functions between laparoscopic and conventional surgery for colorectal cancers. Methods In this prospective study, a laparoscopic group ( n =20) was compared with an open group ( n =20). Blood samples were obtained at 1, 24, 48, and 72 hours postoperation respectively to perform liver function tests, including total bilirubin (TBil), albumin (Alb), gamma-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Results Of the both groups, serum Alb and ALP levels decreased, and TBil and GGT levels remained unchanged. Postoperative ALT and AST levels transiently increased by threefold and returned to near baseline levels at 72 hours. There was no postoperative liver failure or mortality in both groups. Conclusions Laparoscopic colorectal surgery results in postoperative elevation of hepatic transaminases but does not adversely alter hepatic functions to any greater extent than open colorectal surgery.