摘要
AIM: The purpose of this study was to investigate the effectof laparoscopic surgery on liver function in humans and thepossible mechanisms behind such effect.METHODS: Blood samples from 286 patients whounderwent laparoscopic cholecystectomy (LC) and 40patients who underwent open cholecystectomy (OC) weretested for liver function by measuring the level of serumalanine aminotrasferase (ALT) and aspartate aminotrasferase(AST) before and after the operations. The same tests werealso applied to 18 laparoscopic colorectal cancer resection(LCR) patients and 23 open colorectal cancer resection (OCR)patients to determine whether CO2 pneumoperitoneum couldalter the serum liver enzymes.RESULTS: The level of serum ALT and AST increasedsignificantly during the first 48 hours post operations in bothLC and LCR patients. However, no significant change of theserum liver enzymes was detected in both OC and OCRpatients. As a result, there was statistically significantdifference in change of both ALT and AST levels betweenLC and OC patients and LCR and OCR patients, respectively.By the 7th day post operation, the level of both enzymesreturned to normal values in LC, OC and OCR patients exceptLCR patients whose enzymes remained at a higher level.CONCLUSION: Transient elevation of hepatic transaminasesoccurred after laparoscopic surgery. The major causativefactor seemed to be the CO2 pneumoperitoneum. In mostof the laparoscopic surgery patients, the transient elevationof serum liver enzymes showed no apparent clinicalimplications. However, if preoperative liver function was verypoor, laparoscopic surgery may not be the best choice forthe treatment of patients with certain abdominal diseases.
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 CO_2 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 both 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 CO_2 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 for the treatment of patients with certain abdominal diseases.
