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Elevation of liver function tests after laparoscopic gastrectomy using a Nathanson liver retractor.
Yousuke Kinjo1, Hiroshi Okabe, Kazutaka Obama
1Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
World Journal of Surgery
|October 1, 2011
Summary
Laparoscopic gastrectomy using a Nathanson retractor frequently elevates liver function tests (LFTs). Surgeons should minimize direct liver manipulation during this procedure to prevent postoperative liver dysfunction.
Area of Science:
- Hepatology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Elevated liver function tests (LFTs) post-laparoscopic surgery may stem from pneumoperitoneum or direct liver injury.
- Investigating the impact of Nathanson retractors in laparoscopic gastrectomy (LG) on LFTs compared to open gastrectomy (OG) is crucial.
Purpose of the Study:
- To determine if laparoscopic gastrectomy (LG) with a Nathanson retractor is associated with elevated postoperative liver function tests (LFTs) compared to open gastrectomy (OG).
Main Methods:
- A retrospective cohort study compared 199 LG patients with 120 OG patients.
- Liver function tests (AST, ALT, total bilirubin) were measured preoperatively and on postoperative days 1, 3, and 7.
- Laparoscopic and open colectomy patients were also compared to assess pneumoperitoneum effects.
Main Results:
- Both LG and OG showed postoperative LFT elevation, but LG had significantly higher mean ALT and total bilirubin levels.
- Abnormal LFT elevation occurred more frequently in the LG group (50%) versus the OG group (12%).
- LG was significantly associated with postoperative liver dysfunction (OR = 7.99; 95% CI = 3.69-18.85).
Conclusions:
- Laparoscopic gastrectomy (LG) using a Nathanson retractor is linked to frequent elevations in liver function tests (LFTs).
- Minimizing intraoperative liver damage during LG with this retractor is recommended to reduce postoperative liver dysfunction.
