title: Transient liver dysfunction after laparoscopic gastrectomy for gastric cancer patients.
abstract: BACKGROUND
  The effect of laparoscopic surgery under CO2 pneumoperitoneum on liver function is not clear. The aim of this study was to clarify whether laparoscopy-assisted distal gastrectomy (LADG) is associated with changes in liver function compared with open distal gastrectomy (ODG).
  
  
  METHODS
  A total of 205 patients who underwent LADG (n = 147) or ODG (n = 58) between January 1994 and April 2004 were included in this study. Liver function tests-aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, total bilirubin-were examined before surgery and at 1, 3, and 7 days after surgery. The postoperative clinical course was compared between the two groups.
  
  
  RESULTS
  AST levels on day 1 and ALT levels on days 1 and 3 were significantly higher in the LADG group. Albumin levels showed a marked decrease after operation in both groups, but the level recovered more rapidly in the LADG group than in the ODG group, showing significant differences on days 3 and 7. The total bilirubin levels remained unchanged from baseline. The postoperative complication rate was similar in the two groups, although 3 LADG patients among the 27 patients with liver disease suffered severe enteritis.
  
  
  CONCLUSIONS
  Transient liver dysfunction was documented in patients after laparoscopic gastrectomy under CO2 pneumoperitoneum.
authors.affiliation: Department of Surgery I, Oita University Faculty of Medicine, 1-1 Hasama-machi, Oita, 879-5593, Japan. teto@med.oita-u.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Etoh
authors.forename: Norio
authors.initials: N
authors.lastname: Shiraishi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tajima
authors.forename: Akio
authors.initials: A
authors.lastname: Shiromizu
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasuda
authors.forename: Masafumi
authors.initials: M
authors.lastname: Inomata
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000201:enzymology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011183:Postoperative Complications / Q000097:blood*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome