Introduction: In this modern era Laparoscopic surgery has evoked marked changes in approach to surgical diseases. The “Minimally invasive surgery “(MIS), now turned into “Minimal Access Surgery” (MAS) has prompted us to prompted us to perform most of the operations by Laparoscopic technique. Main advantages of laparoscopic surgery include; reduction of tissue trauma due to small skin incisions and reduction in adhesion formation. All Laparoscopic procedures are usually performed by creating pneumoperitoneum. Carbon dioxide is most commonly used inert gas to create pneumoperitoneum. Apart from many advantages in Laparoscopic procedures; effects of pneumoperitoneum on the cardiovascular and respiratory system resulting in several pathophysiological changes in the patients have been reported. Recently many studies have disclosed ‘unexplained’ changes in postoperative liver function tests in patients undergoing laparoscopic procedures. These studies demonstrate that transient elevation of hepatic enzymes could occur after laparoscopic procedures. No causes for this elevation are documented so far. CO2 pneumoperitoneum might be one of the main reasons for the change of serum liver enzymes. So we decided to perform a study to correlate the changes in serum liver enzymes pre-operative and post operation.
Aim and Objective: The purpose of this study was to investigate the effect of laparoscopic surgeries on liver function test and the possible mechanisms behind such effect in our hospital in the Department of General Surgery at Sri Adichunchanagiri Hospital and Research Center (AH & RC), the teaching hospital attached to Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya by statistical analysis.
Material and Methods: This was a prospective study conducted in 100 patients who were undergoing various types of laparoscopic surgery performed using CO2 to create pneumoperitoneum under intraperitoneal pressure of 12-14mmHg during the period of 18 months from January 2017 to June 2018 in our Hospital. Blood sampling were collected both preoperatively and post operatively on day 1 and day 5 for liver function tests along with routine investigations.
Result: The level of serum bilirubin, serum aspartate amino transferase, serum alanine amino transferase and alkaline phosphatase increased significantly during the first 24 hours post operatively. These values returned to near pre-operative value by post-operative day 5.
Interpretation and Conclusion: In this study we conclude that there was a transient changes in serum Bilirubin and Liver Enzymes in the POD-1 which reverted back to near normal to the pre-operative level by POD-5. There was no complication, no morbidity and no mortality. It is concluded that the changes in LFT is probably due to CO2 pneumoperitoneum. Laparoscopic procedures can be done safely in a patient in the presence of normal Liver function test and may not be safe in presence of serious Liver disorder.