ABSTRACT
To find out the alterations in hepatic functions after laparoscopic cholecystectomy and the possible mechanisms behind such effect. A prospective analytic study. The study was conducted in surgical unit-1; Allied Hospital Faisalabad, from January 1st, 2009 to June 30th, 2009. With approval from the institutional ethical committee and informed consent, as per inclusion and exclusion criteria, 100 patients for laparoscopic cholecystectomy were included in the study. The blood samples of the patients were collected to test liver enzymes; bilirubin, alanine aminotransferase [ALT] aspartate aminotransferase [AST] and alkaline phosphatase [ALP] once preoperatively and then on 2nd and 10th post operative days. The preoperative values were compared with that of postoperative values. During LC intraabdominal pressure for pneumoperitoneum was maintained at 14 mmHg of CO2 and the duration of CO2 insufflation was measured. Forty eight hours after LC, levels of ALT, AST and bilirubin were found to be increased [ALT: 51.11 U/L, P<0.001; AST: 53.79 U/L, p < 0.001 and Bilirubin: 1.38mg/dl P < 0.001 which were statistically significant. Moreover, these hepatic enzymes were significantly increased in patients who had longer durations of CO2 insufflations. The changes in alkaline phosphatase measurements were found to be non significant. The levels of hepatic functions returned to normal or near normal values in samples of 10th post operative day. Transient alterations in hepatic functions are frequently observed after uneventful laparoscopic cholecystectomy, which clinically appear to be insignificant. CO2 Pneumoperitoneum seems to be the main reason for theses changes but other factors may also contribute