Impact of Carbon Dioxide Pneumoperitoneum on Liver Function Tests in Laparoscopic Cholecystectomy, A Prospective Study

Muhammad Shahbaz Nazir; Maria  Nawaz; Afzal Saeed  Awan; Hafiza Ayesha  Nawaz; Laiba  Iqbal; Muhammad  Irfan

doi:10.51253/pafmj.v75i6.11826

Authors

Muhammad Shahbaz Nazir Department of General Surgery, Combined Military Hospital, Multan/National University of Medical Sciences (NUMS) Pakistan
Maria Nawaz Department of Pathology, Children Hospital, Faisalabad Pakistan
Afzal Saeed Awan Department of General Surgery, Combined Military Hospital, Multan/National University of Medical Sciences (NUMS) Pakistan
Hafiza Ayesha Nawaz National University of Sciences & Technology, Islamabad Pakistan
Laiba Iqbal Department of General Surgery, District Headquarters Hospital, Sargodha Pakistan
Muhammad Irfan Department of General Surgery, Combined Military Hospital, Sialkot/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i6.11826

Keywords:

Carbon dioxide, Cholelithiasis, Laparoscopic Cholecystectomy, Liver Function Tests, Pneumoperitoneum.

Abstract

Objective: To evaluate the impact of carbon dioxide pneumoperitoneum on liver function tests in patients undergoing laparoscopic cholecystectomy for a benign disease as an elective surgery.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Army Liver Transplant Unit, Pak Emirates Military Hospital Rawalpindi, Pakistan from Mar 2021 to Feb 2024.

Methodology: The study included 455 patients who underwent elective laparoscopic cholecystectomy in a tertiary care hospital in accordance with the inclusion and exclusion criteria. All patients of 18-80 years of age with normal LFTs were included and those with liver and associated diseases that could affect the LFTs were excluded. The detailed medical history and laboratory findings were recorded preoperatively and post operatively on the 1st, 3rd, and 7th post operative day and evaluated for any significant change in values.

Results: ALP and LDH showed a rise in serum values after surgery. The mean values before surgery for ALP and LDH were 88.09±30.19 U/L and 201.11±42.46 U/L respectively. After seven days of surgery, the mean values of ALP and LDH were 91.69±32.86 U/L and 212.16±44.31 U/L respectively with p-value <0.05. However, no significant change in the mean values of serum levels of ALT, AST, bilirubin and albumin was observed during the preoperative and post-operative period.

Conclusion: A temporary rise of liver enzyme levels, such as ALP and LDH may be seen in patients undergoing laparoscopic cholecystectomy due to CO2 pneumoperitoneum, but these values return to normal after one week with no adverse effects.

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