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Changes in liver function tests after laparoscopic cholecystectomy: not so rare, not always ominous
A A Saber1, R D Laraja, H I Nalbandian
1Department of Surgery, Mount Sinai School of Medicine/Cabrini Program, New York University School of Medicine, New York 10003, USA.
The American Surgeon
|August 5, 2000
Summary
Transient elevations in liver enzymes alanine aminotransferase (ALT) and aspartate amino transferase (AST) are common after laparoscopic cholecystectomy (LC). These liver function test changes are typically clinically insignificant and resolve within seven days.
Area of Science:
- Hepatology
- Surgical Gastroenterology
Background:
- Elevated liver enzymes alanine aminotransferase (ALT) and aspartate amino transferase (AST) can be incidentally found after laparoscopic cholecystectomy (LC).
- The clinical significance and incidence of these transient liver function test (LFT) abnormalities require investigation.
Purpose of the Study:
- To determine the incidence and clinical significance of elevated ALT and AST levels following uneventful laparoscopic cholecystectomy (LC).
Main Methods:
- Compared LFTs in patients undergoing LC (n=55) versus open cholecystectomy (OC, n=16).
- Collected LFTs preoperatively and on postoperative days 1, 2, and 7.
- Excluded patients with abnormal preoperative LFTs, prior biliary interventions, or postoperative complications.
Main Results:
- 58.2% of LC patients showed doubled ALT levels within 48 hours, versus 6.3% in OC patients.
- 38.2% of LC patients showed doubled AST levels within 48 hours, versus 6.3% in OC patients.
- LFTs normalized by postoperative day 7 in both groups.
Conclusions:
- Significant, transient increases in ALT and AST are common after uneventful LC.
- These LFT elevations are clinically silent in patients with normal baseline liver function.
- Enzyme levels return to normal within one week post-surgery.