Aminotransferases after experimental pneumoperitoneum in dogs.
BACKGROUND
Laparoscopic surgery has rapidly become a popular and widely used technique. Elevated intra abdominal pressure due to gas insufflation for laparoscopic surgery may result in a number of local and systemic effects on the organism. The effects of pneumoperitoneum on the cardiovascular and respiratory system are well known today, but very few studies have been carried out on the consequences of pneumoperitoneum on hepatic integrity. The aim of the present study was to assess changes in aminotransferases, bilirubin and prothrombin time after pneumoperitoneum in dogs.


METHODS
The effects of different levels and duration of intra abdominal pressure and different gases on liver function test were investigated in dogs. The levels of aspartate aminotransferase, alanine aminotransferase, total and direct bilirubin, and prothrombin time, according to the duration and the level of pneumoperitoneum and gas, were measured at 6, 12, 24 and 48 h of desufflation.


RESULTS
The levels of total bilirubin, direct bilirubin and prothrombin time showed no significant alteration. A statistically significant (P < 0.01) elevation of aspartate aminotransferase and alanine aminotransferase was recorded in the group of animals with higher intra abdominal pressure and longer duration of pneumoperitoneum. They returned to normal values within 48 h.


CONCLUSIONS
Transient elevation of hepatic transaminases occurred after laparoscopic surgery, but they returned to normal values within 48 h. These increases were more prominent with higher and longer intra abdominal pressures irrespective of the type of insufflated gas. Alteration in aminotransferases was not associated with any clinical signs of hepatic dysfunction in experimental animals.
Nesek-Adam
V
V
Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh General Hospital, Zagreb, Croatia. tihomir.adam@zg.tel.hr
Rasic
Z
Z
Kos
J
J
Vnuk
D
D
D000410:Alanine Transaminase / Q000097:blood*; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood*; D001663:Bilirubin / Q000097:blood; D004285:Dogs; D010535:Laparoscopy; D011028:Pneumoperitoneum, Artificial; D011312:Pressure
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin