Liver enzyme alterations after laparoscopic cholecystectomy

We aimed to investigate the alterations in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl-transferase (GGT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in patients who had undergone laparoscopic cholecystectomy (LC) and compare these changes with those occurring after open cholecystectomy (OC). Of 267 patients who underwent LC between January 2003 and December 2005, 86 patients without complications were eligible for study. Twenty-six patients who underwent OC during the same interval were also enrolled in the study as a control group. Blood samples were taken preoperatively and 24 hours after operation for biochemical tests. Statistical analyses revealed significant increases in AST, ALT, GGT and LDH levels in the LC group postoperatively. Compared with the OC group, the differences between elevations of enzyme levels were also significant for LC group. We conclude that these enzyme elevations could mostly be attributed to the negative effects of the pneumoperitoneum on the hepatic blood flow. Although these changes do not seem to be clinically important, care should be taken before deciding to perform LC in patients with hepatic insufficiency.