Evaluation of liver enzymes following elective laparoscopic cholecystectomy: are they really elevated?

Studies made on a small number of patients have demonstrated significant modifications in liver function tests (LFT) following laparoscopic cholecystectomy.

To assess retrospectively, post-operative LFT in a large group of patients undergoing elective uneventful laparoscopic cholecystectomy.

Between 1999 and 2007, 1,997 patients were scheduled for laparoscopic cholecystectomy. In 1,034 patients (the study group), the surgery was elective and normal LFT were measured a day prior to surgery. Exclusion criteria included acute cholecystitis, acute pancreatitis, pre-operative endoscopic retrograde cholangio-pancreatography, medication that may affect liver metabolism, and intra-operative complications. Liver function tests were evaluated pre-operatively and 20-24 h post-operatively.

The mean post-operative value of liver function tests and amylase were well within normal limits, although mild increase was inspected in part of it. We observed post-operative mild hepatic enzyme increase only in 41 patients (3.9%), in nine of these, choledocholithiasis was found.

In contrary to previously published data, we have validated, in light of our broad sampling, that the induction of CO(2) pneumoperitoneum does not cause deranged liver function tests.