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Volume 13 Issue 7 (July) 2024

Original Articles

To determine the impact of laparoscopic surgery on liver function
Rajendrakumar Natvarlal Nayak

Aim: To determine the impact of laparoscopic surgery on liver function. Material and methods: The study included 50 patients who were scheduled to undergo elective laparoscopic procedures for various indications. Fifty patients were enrolled in the study. Patients aged 18 years and older, scheduled for elective laparoscopic surgery, including cholecystectomy, hernia repair, or other abdominal procedures and who provided written informed consent were included in the study. The occurrence of any postoperative complications, including infections, bile leaks, or hemorrhage, Length of hospital stay was measured. The impact on liver function was assessed based on changes in the LFTs from baseline to the postoperative period. An elevation of more than 2 times the upper limit of normal for ALT or AST was considered significant. Changes in ALP, total bilirubin, and albumin levels were also monitored and analyzed. Patients were closely monitored during their hospital stay and followed up for 30 days post-surgery. Results: The mean ± SD values were: ALT 25 ± 8 U/L (normal range 7-56 U/L), AST 22 ± 7 U/L (normal range 10-40 U/L), ALP 75 ± 20 U/L (normal range 44-147 U/L), total bilirubin 0.8 ± 0.2 mg/dL (normal range 0.1-1.2 mg/dL), and albumin 4.0 ± 0.5 g/dL (normal range 3.5-5.0 g/dL). These results confirm the hepatic stability of the patients before undergoing surgery. The intraoperative data reveal that the majority of surgeries were cholecystectomies (60%), followed by hernia repairs (30%), and other abdominal procedures (10%). Most surgeries (70%) were completed in less than 2 hours, while 30% took 2 hours or more. Regarding CO2 insufflation pressure, 60% of the surgeries used pressures ≥12 mmHg, and 40% used pressures <12 mmHg. The postoperative LFTs indicate a transient elevation in liver enzyme levels following laparoscopic surgery. On postoperative day 1, mean ALT levels increased to 40 ± 15 U/L and AST to 38 ± 14 U/L. By day 3, these levels slightly decreased to ALT 35 ± 12 U/L and AST 32 ± 11 U/L, and by day 7, they further normalized to ALT 28 ± 10 U/L and AST 25 ± 9 U/L. ALP, total bilirubin, and albumin levels showed minimal fluctuations, with ALP peaking at 80 ± 25 U/L on day 1 and normalizing to 70 ± 18 U/L by day 7. Total bilirubin and albumin levels remained stable, indicating minimal impact on these parameters. The postoperative outcomes show that 70% of patients had a hospital stay of less than 7 days, while 30% stayed 7 days or more. ICU admission was required for 20% of the patients, reflecting the severity or complications of their conditions. Conclusion: In conclusion, this study provides valuable insights into the demographic characteristics, intraoperative variables, and postoperative outcomes related to liver function in patients undergoing laparoscopic surgery. The findings corroborate existing literature, highlighting the transient and manageable nature of liver enzyme elevations post-surgery.

 
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