Elevation of serum liver enzymes after laparoscopic cholecystectomy
Laparoscopic cholecystectomy (LC) has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gallbladder diseases. However, it has been noticed that (following LC) the serum level of certain liver enzymes raises markedly in patients who had preoperatively norm...
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| Veröffentlicht in: | New Zealand medical journal 2005-02, Vol.118 (1210), p.U1317-U1317 |
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| container_title | New Zealand medical journal |
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| creator | Sakorafas, George Anagnostopoulos, George Stafyla, Vania Koletis, Theofilos Kotsifopoulos, Nikolaos Tsiakos, Stavros Kassaras, George |
| description | Laparoscopic cholecystectomy (LC) has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gallbladder diseases. However, it has been noticed that (following LC) the serum level of certain liver enzymes raises markedly in patients who had preoperatively normal liver enzyme values.
We measured serum values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, bilirubin, and international normalized ratio (INR) in 72 consecutive patients who underwent laparoscopic cholecystectomy and 36 consecutive patients who underwent open cholecystectomy (OC). During laparoscopic surgery, the intra-abdominal pressure was maintained at 14 mmHg of CO2. To assess liver function, serum liver enzymes were measured before operations and at 1,3,7, and 10 days postoperation.
Mortality was nil. Twenty-four hours after the procedure, ALT and AST increased statistically significantly in the LC group (ALTLC24: 87.1+/-24.2 U/L P |
| format | Article |
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We measured serum values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, bilirubin, and international normalized ratio (INR) in 72 consecutive patients who underwent laparoscopic cholecystectomy and 36 consecutive patients who underwent open cholecystectomy (OC). During laparoscopic surgery, the intra-abdominal pressure was maintained at 14 mmHg of CO2. To assess liver function, serum liver enzymes were measured before operations and at 1,3,7, and 10 days postoperation.
Mortality was nil. Twenty-four hours after the procedure, ALT and AST increased statistically significantly in the LC group (ALTLC24: 87.1+/-24.2 U/L P<0.001; ASTLC24:82.8+/-19.1 U/L, p<0.001)--whereas in the OC group, 24 hours after the procedure, the serum value of ALT and AST was above the upper normal limits in only in one patient. A further increase in serum ALT and AST value was observed in the LC group (ALTLC72: 99.3+/-19.5 U/L, p<0.001; ASTLC72H: 103.5+/-21.6 U/L, p<0.001) 72 hours after the operation. The mean value of ALT and AST in the OC group was within normal limits 72 hours after the procedure. Slow return to normality occurred 7-10 days after the procedure in the LC group.
Alterations in hepatic function occur after laparoscopic cholecystectomy and appear to be clinically insignificant. CO2 pneumoperitoneum seems to be the main reason for theses changes but other factors may also contribute. We also measured the values of ALP, GGT, INR and bilirubin. No statistically significant increase was noticed in any groups between the preoperative and postoperative values of these enzymes.</description><identifier>EISSN: 1175-8716</identifier><identifier>PMID: 15776093</identifier><language>eng</language><publisher>New Zealand</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase - blood ; Aspartate Aminotransferases - blood ; Bilirubin - blood ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Female ; gamma-Glutamyltransferase - blood ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Postoperative Period</subject><ispartof>New Zealand medical journal, 2005-02, Vol.118 (1210), p.U1317-U1317</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15776093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sakorafas, George</creatorcontrib><creatorcontrib>Anagnostopoulos, George</creatorcontrib><creatorcontrib>Stafyla, Vania</creatorcontrib><creatorcontrib>Koletis, Theofilos</creatorcontrib><creatorcontrib>Kotsifopoulos, Nikolaos</creatorcontrib><creatorcontrib>Tsiakos, Stavros</creatorcontrib><creatorcontrib>Kassaras, George</creatorcontrib><title>Elevation of serum liver enzymes after laparoscopic cholecystectomy</title><title>New Zealand medical journal</title><addtitle>N Z Med J</addtitle><description>Laparoscopic cholecystectomy (LC) has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gallbladder diseases. However, it has been noticed that (following LC) the serum level of certain liver enzymes raises markedly in patients who had preoperatively normal liver enzyme values.
We measured serum values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, bilirubin, and international normalized ratio (INR) in 72 consecutive patients who underwent laparoscopic cholecystectomy and 36 consecutive patients who underwent open cholecystectomy (OC). During laparoscopic surgery, the intra-abdominal pressure was maintained at 14 mmHg of CO2. To assess liver function, serum liver enzymes were measured before operations and at 1,3,7, and 10 days postoperation.
Mortality was nil. Twenty-four hours after the procedure, ALT and AST increased statistically significantly in the LC group (ALTLC24: 87.1+/-24.2 U/L P<0.001; ASTLC24:82.8+/-19.1 U/L, p<0.001)--whereas in the OC group, 24 hours after the procedure, the serum value of ALT and AST was above the upper normal limits in only in one patient. A further increase in serum ALT and AST value was observed in the LC group (ALTLC72: 99.3+/-19.5 U/L, p<0.001; ASTLC72H: 103.5+/-21.6 U/L, p<0.001) 72 hours after the operation. The mean value of ALT and AST in the OC group was within normal limits 72 hours after the procedure. Slow return to normality occurred 7-10 days after the procedure in the LC group.
Alterations in hepatic function occur after laparoscopic cholecystectomy and appear to be clinically insignificant. CO2 pneumoperitoneum seems to be the main reason for theses changes but other factors may also contribute. We also measured the values of ALP, GGT, INR and bilirubin. No statistically significant increase was noticed in any groups between the preoperative and postoperative values of these enzymes.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alanine Transaminase - blood</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Bilirubin - blood</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy, Laparoscopic</subject><subject>Female</subject><subject>gamma-Glutamyltransferase - blood</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Period</subject><issn>1175-8716</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1j81KxDAURoMgzjj6CpKVu0Ka9CbpUsr4AwOzmX1J0xusJE1N2oH69A44rg4fHD44N2RblgoKrUq5Ifc5fzHGAWp2RzYlKCVZLbak2Xs8m3mII42OZkxLoH44Y6I4_qwBMzVuvixvJpNitnEaLLWf0aNd84x2jmF9ILfO-IyPV-7I6XV_at6Lw_Hto3k5FBNUokCurOCMKQbMdT06I53gWqPUDBwHxi130kmlLEjbO1nXSlcauh6MA-7Ejjz_3U4pfi-Y5zYM2aL3ZsS45FYq4Lxi-iI-XcWlC9i3UxqCSWv7Xy1-AQj2Uyc</recordid><startdate>20050225</startdate><enddate>20050225</enddate><creator>Sakorafas, George</creator><creator>Anagnostopoulos, George</creator><creator>Stafyla, Vania</creator><creator>Koletis, Theofilos</creator><creator>Kotsifopoulos, Nikolaos</creator><creator>Tsiakos, Stavros</creator><creator>Kassaras, George</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20050225</creationdate><title>Elevation of serum liver enzymes after laparoscopic cholecystectomy</title><author>Sakorafas, George ; Anagnostopoulos, George ; Stafyla, Vania ; Koletis, Theofilos ; Kotsifopoulos, Nikolaos ; Tsiakos, Stavros ; Kassaras, George</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p543-e27c32007050fbdefa6f3288e6805f2502c2f6f677c56cdf69978485bd5af52f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alanine Transaminase - blood</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Bilirubin - blood</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy, Laparoscopic</topic><topic>Female</topic><topic>gamma-Glutamyltransferase - blood</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Period</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sakorafas, George</creatorcontrib><creatorcontrib>Anagnostopoulos, George</creatorcontrib><creatorcontrib>Stafyla, Vania</creatorcontrib><creatorcontrib>Koletis, Theofilos</creatorcontrib><creatorcontrib>Kotsifopoulos, Nikolaos</creatorcontrib><creatorcontrib>Tsiakos, Stavros</creatorcontrib><creatorcontrib>Kassaras, George</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>New Zealand medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sakorafas, George</au><au>Anagnostopoulos, George</au><au>Stafyla, Vania</au><au>Koletis, Theofilos</au><au>Kotsifopoulos, Nikolaos</au><au>Tsiakos, Stavros</au><au>Kassaras, George</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevation of serum liver enzymes after laparoscopic cholecystectomy</atitle><jtitle>New Zealand medical journal</jtitle><addtitle>N Z Med J</addtitle><date>2005-02-25</date><risdate>2005</risdate><volume>118</volume><issue>1210</issue><spage>U1317</spage><epage>U1317</epage><pages>U1317-U1317</pages><eissn>1175-8716</eissn><abstract>Laparoscopic cholecystectomy (LC) has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gallbladder diseases. However, it has been noticed that (following LC) the serum level of certain liver enzymes raises markedly in patients who had preoperatively normal liver enzyme values.
We measured serum values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, bilirubin, and international normalized ratio (INR) in 72 consecutive patients who underwent laparoscopic cholecystectomy and 36 consecutive patients who underwent open cholecystectomy (OC). During laparoscopic surgery, the intra-abdominal pressure was maintained at 14 mmHg of CO2. To assess liver function, serum liver enzymes were measured before operations and at 1,3,7, and 10 days postoperation.
Mortality was nil. Twenty-four hours after the procedure, ALT and AST increased statistically significantly in the LC group (ALTLC24: 87.1+/-24.2 U/L P<0.001; ASTLC24:82.8+/-19.1 U/L, p<0.001)--whereas in the OC group, 24 hours after the procedure, the serum value of ALT and AST was above the upper normal limits in only in one patient. A further increase in serum ALT and AST value was observed in the LC group (ALTLC72: 99.3+/-19.5 U/L, p<0.001; ASTLC72H: 103.5+/-21.6 U/L, p<0.001) 72 hours after the operation. The mean value of ALT and AST in the OC group was within normal limits 72 hours after the procedure. Slow return to normality occurred 7-10 days after the procedure in the LC group.
Alterations in hepatic function occur after laparoscopic cholecystectomy and appear to be clinically insignificant. CO2 pneumoperitoneum seems to be the main reason for theses changes but other factors may also contribute. We also measured the values of ALP, GGT, INR and bilirubin. No statistically significant increase was noticed in any groups between the preoperative and postoperative values of these enzymes.</abstract><cop>New Zealand</cop><pmid>15776093</pmid></addata></record> |
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| ispartof | New Zealand medical journal, 2005-02, Vol.118 (1210), p.U1317-U1317 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Alanine Transaminase - blood Aspartate Aminotransferases - blood Bilirubin - blood Cholecystectomy Cholecystectomy, Laparoscopic Female gamma-Glutamyltransferase - blood Humans International Normalized Ratio Male Middle Aged Postoperative Period |
| title | Elevation of serum liver enzymes after laparoscopic cholecystectomy |
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