title: Laparoscopic cholecystectomy: evaluation of liver function tests.
abstract: OBJECTIVE
  The changes in liver function tests (LFTs) after laparoscopic cholecystectomy (LC) have been described in the literature. The aims of this study are to value the increases of the LFTs and its clinical appearance after LC. Furthermore we studied the correlation of the changes of LFTs with the operative time and the role of elevated BMI.
  
  
  METHODS
  In the period October 2012 - May 2013, 81 patients undergone to elective LC were analyzed by examining bilirubin, AST, ALT, ALP, GGT at the admission, 1 and 3 days after surgery. Correlations of the length of intervention and BMI with changes of LFTs are evaluated. During surgery, the intrabdominal pressure has been 12 mmHg in all patients. The Student t test, PCC (Pearson's correlation coefficient) OR (odds ratio) were performed to determine statistical significance.
  
  
  RESULTS
  The level of (serum) AST, ALT increased significantly during 24-48 hours after LC (p < 0,0001). The increase of (total and direct) bilirubin has not the statistical significance. On the contrary ALP, GGT was significantly decreased (p < 0,001). Three days after surgery LFTs returned to normal level in the patients with previous normal level of tests. The length of intervention doesn't show correlations with changes of LFTs (PCC 0.2). the BMI >28 led increased risk of changes of LFTs (OR 2.44).
  
  
  CONCLUSIONS
  The changes of LFTs are transient and clinically silent in patients with a normal liver function. Nevertheless must be evaluated preoperative BMI and liver dysfunction.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Neri
authors.forename: Antonio
authors.initials: A
authors.lastname: Ambrosi
authors.forename: Alberto
authors.initials: A
authors.lastname: Fersini
authors.forename: Nicola
authors.initials: N
authors.lastname: Tartaglia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Cianci
authors.forename: Francesco
authors.initials: F
authors.lastname: Lapolla
authors.forename: Immacolata
authors.initials: I
authors.lastname: Forlano
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin