Elevated liver enzymes as an operative complication of gastric bypass surgery.
BACKGROUND
A rise in liver function tests (LFTs) had been noted in a patient following gastric bypass. This was studied in a subsequent gastric bypass patient, to determine if this rise in LFTs occurred sometime between placement of the upper abdominal retractors but before the retractors were removed.


METHODS
LFTs were drawn preoperatively, immediately before retractor placement, immediately before retractor removal, 1 and 3 hours postoperatively, and postoperatively for 5 days until discharge.


RESULTS
LFTs rose after liver retractor placement and remained elevated for 3 days before returning to normal.


CONCLUSIONS
The authors postulate that surgical retractor placement may have caused the patient's acute LFT elevation. Specifically, direct mechanical pressure may result in a transient decrease in hepatic blood-flow.
Resident Anesthesiology, University of South Florida College of Medicine, Department of Anesthesiology, Tampa, FL 33612, USA.
Julie
J
Saranita
Roy G
RG
Soto
Dan
D
Paoli
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008102:Liver Circulation; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011312:Pressure
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase