ABSTRACT
Introduction: Cholelithiasis is one of the most commonsurgical diseases. Laparoscopic cholecystectomy has beenuniversally accepted as gold standard for treatment ofcholelithiasis. Although many studies have shown postoperative changes in liver function tests after high pressurepneumoperitoneum during laparoscopic cholecystectomy,but very few studies have investigated the effects of lowpressure pneumoperitoneum on hepatic functions.The presentstudy was designed to compare post-operative changes inliver function tests among patients randomized to either lowpressure laparoscopic cholecystectomy(LPLC) (i.e.8 mmHg)or high pressure laparoscopic cholecystectomy(HPLC) (i.e.14mmHg).Material and methods: After taking a well informed writtenconsent,150 cases undergoing laparoscopic cholecystectomywere enrolled in the study and randomised preoperatively intotwo groups (LPLC and HPLC). Liver function tests (LFTs)including Total Bilirubin, Conjugated Bilirubin, AspartateTransaminase (AST), Alkaline Phosphatase(ALP), AlanineTransaminase (ALT), Gamma-glutamyl Transferase (GGT),Total Serum Protein, Total Serum Albumin) were done onpost-operative day (POD) 1 and day 7 and compared withpreoperative LFTs in both groups.Results: The study demonstrated significant increase inConjugated bilirubin on POD 1(p < .001), AST on POD1 (p: .005), ALT on POD 1 (p <.001), ALP on POD 1(p < .001) in HPLC as compared to LPLC patients. LFTsin both groups were found to be normal on POD 7 withoutsignificant difference between the two groups.Conclusion: Low pressure laparoscopic cholecystectomy hasless adverse effects on liver functions as compared to the highpressure laparoscopic cholecystectomy