THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS

Hazem Helmy, Ahmed; Abbass, Mohamed; Farouk Youssef, Youssef; I. Nafeh, Ayman; Elkhyatt, H.; Saleh, Azza

doi:10.21608/ejsur.2001.376928

THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS

Document Type : Original Article

Authors

¹ Department of Surgery, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.

² Department of Gastroentrology, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.

³ Department of hepatology, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.

⁴ Department of clinical Chemistry, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.

10.21608/ejsur.2001.376928

Abstract

The laparascopic Cholecystectomy is the new and accepted procedure for removal of the diseased gall bladder stones.The procedure is standardized and now it is world wide done in department of general surgery. The adverse effects concerning the pneumoperitonium particularly the increase in the intra abdominal pressure and its effect concerning the heamodynamic and ventilatory effects are studied before.The effect of such increase in the intra abdominal pressure on the liver enzymes was reported before. In our study we looked at the liver function before and after 24 hours of doing Cholecystectomy in (76 patients). The Laparoscopic Cholecystectomy group were the IAP was 12-15 mmhg (LAC 43 patients) and Minilaparotomy for Cholecystectomy group ( MLC 33 patients).
It was found that the liver transaminase enzymes were all affected in all patients “transaminites”. In those who had
compansated liver function and potentially liver disease i.e. Cirrhotic liver with child A and B due to HCV and HBV who
under went laparoscopic cholycystectomy the liver functions reasched up to 3 -5 -7 times normal. In the Minilaparotomy for Cholecystectomy the enzymes reached 1.5 times normal in normal liver patients and 7 times normal in the compansated liver patients.
The increase in the intrabdominal pressure was the variable factor among those two groups. We suggest that the
pneumoperitonium during laparascopic Cholecystectomy initiated some form of ischeamia and this has lead to Ischeamia Reperfusion Injury that had affected the liver function.

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