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INTRA-ABDOMINAL PRESSURE AS A MODULATOR OF BIOCHEMICAL INDICATORS OF HEPATIC FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

By
Mladen Kasalović Orcid logo ,
Mladen Kasalović
Contact Mladen Kasalović

Department of Surgery, Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Gojko Igrutinović Orcid logo ,
Gojko Igrutinović

Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Saša Dimić Orcid logo ,
Saša Dimić

Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Nikola Miljković Orcid logo ,
Nikola Miljković

Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Aleksandar Jakovljević Orcid logo ,
Aleksandar Jakovljević

Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Zlatan Elek Orcid logo ,
Zlatan Elek

Faculty of Medicine, University of Priština - Kosovska Mitrovica , Mitrovica , Kosovo

Marija Milanović Orcid logo
Marija Milanović

Surgery, Clinical Hospital Center Kosovska Mitrovica , Kosovska Mitrovica , Serbia

Abstract

Laparoscopic cholecystectomy is the standard treatment for gallbladder disease; the carbon dioxide pneumoperitoneum required for the procedure may transiently affect liver function. The aim is to examine the evaluation of the impact of different levels of intra-abdominal pressure (IAP) and ASA score on postoperative liver biochemical parameters. A prospective study included 90 patients divided into three groups according to IAP (13, 14, and 15 mmHg; 30 subjects each), with analysis of preoperative and postoperative parameters of liver function. The groups were comparable in terms of age, sex, and body weight, while differences were observed in the type of inflammation and total protein values. After surgery, changes in several biochemical parameters of liver function were recorded, including an increase in the values ​​of direct bilirubin, AST, ALT, and ALP, as well as a decrease in LDH values. The values ​​of total bilirubin, albumin, and total protein did not show significant postoperative changes. Comparison of the groups according to different values ​​of intra-abdominal pressure did not show significant differences in most of the parameters examined, while a statistically significant difference was observed for LDH between the groups. ASA score was associated with postoperative changes in some biochemical parameters of liver function. Laparoscopic cholecystectomy leads to transient changes in liver biochemical parameters without clinically significant damage, whereby intra-abdominal pressure in the usual range has no significant effect, while the general condition of the patient has a greater role in the postoperative response.

 

Author Contributions

Conceptualization, M.K.; Methodology, M.K.; Supervision, M.K. and N.M.; Formal Analysis, G.I. and Z.E.; Funding acquisition, S.D. and M.M.; Investigation, A.J. and Z.E. All authors have read and agreed to the published version of the manuscript.

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There are no sources of funding.

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