title: Changes in the level of serum liver enzymes after laparoscopic surgery.
abstract: OBJECTIVE
  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 aminotransferase (ALT) and aspartate aminotransferase (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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Surgery, the First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2 Road, Guangzhou 510080, Guangdong Province China. tommyt@vip.163.com
authors.forename: Min
authors.initials: M
authors.lastname: Tan
authors.forename: Feng-Feng
authors.initials: FF
authors.lastname: Xu
authors.forename: Jun-Shen
authors.initials: JS
authors.lastname: Peng
authors.forename: Dong-Ming
authors.initials: DM
authors.lastname: Li
authors.forename: Liu-Hua
authors.initials: LH
authors.lastname: Chen
authors.forename: Bao-Jun
authors.initials: BJ
authors.lastname: Lv
authors.forename: Zhen-Xian
authors.initials: ZX
authors.lastname: Zhao
authors.forename: Chen
authors.initials: C
authors.lastname: Huang
authors.forename: Chao-Xu
authors.initials: CX
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase