Liver function disturbances following laparoscopic cholecystectomy: incidence and significance.
BACKGROUND
Unexplained disturbances of liver function parameters after laparoscopic cholecystectomy have been reported in a few previous studies. We aimed to assess the incidence of these disturbances, and their relation to age, sex, duration of surgery, and type of gallbladder inflammation, as well as their clinical significance.


METHODS
All patients undergoing laparoscopic cholecystectomy at Dallah Hospital, Riyadh, Saudi Arabia, during the year 2001 were prospectively evaluated. In all the patients, six parameters of liver function (direct bilirubin, indirect bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase) were assessed before and 24 hours after surgery. Patients with suspected chronic liver disease or common bile duct pathology were excluded. Patients who showed more than a 100% increase in at least one parameter (group I) were compared with those who did not (group II) regarding age, sex, duration of surgery, and type of gallbladder inflammation.


RESULTS
Of the patients, 67.1% showed more than a 100% increase in at least one parameter of liver function. No significant difference was noticed between the two groups regarding age, duration of surgery, or type of gallbladder inflammation. Female patients, however, showed a significantly higher incidence of liver function changes (P = .011). No clinical adverse reactions were reported in those who showed liver function changes.


CONCLUSIONS
Changes in liver function parameters after laparoscopic cholecystectomy are common, carrying no clinical sequalae. They are more common in female patients and are not related to age, duration of surgery, or the acuteness of gallbladder inflammation. Assessment of direct bilirubin and alkaline phosphatase is sufficient for the routine evaluation of these patients postoperatively.
Al-Jaberi
Tareq M
TM
Department of General Surgery, Dallah Hospital, Riyadh, Kingdom of Saudi Arabia. emantaj@hotmail.com
Tolba
Mostafa F
MF
Dwaba
Magdi
M
Hafiz
Mohamed
M
D000328:Adult; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000453:epidemiology* / Q000209:etiology; D008111:Liver Function Tests; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012737:Sex Factors