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Liver Function, Quantified by LiMAx Test, After Major Abdominal Surgery. Comparison Between Open and Laparoscopic
Magnus Kaffarnik1, Gabriel Stoeger2, Julia Liebich2
1Clinic of Surgery, Campus Mitte/Virchow Klinikum, Department of Surgery, Charite-Universitätsmedizin Berlin, Berlin, Germany. magnus.kaffarnik@charite.de.
World Journal of Surgery
|August 26, 2017
Summary
Major abdominal surgery can cause liver dysfunction, detectable with the LiMAx test. Both open and laparoscopic approaches showed similar impacts on liver function and systemic inflammatory response (SIRS).
Area of Science:
- Hepatology
- Surgical Oncology
- Critical Care Medicine
Background:
- Major abdominal surgery can trigger a systemic inflammatory response (SIRS), potentially leading to organ failure.
- Postoperative hepatic dysfunction may arise from altered liver blood flow and reduced oxygen delivery during SIRS.
- The LiMAx test is a potential tool for assessing liver function in this context.
Purpose of the Study:
- To investigate the role of liver dysfunction, measured by the LiMAx test, following major abdominal surgery.
- To compare liver dysfunction between open (laparotomy) and laparoscopic surgical approaches.
- To assess the utility of the LiMAx test in detecting postoperative hepatic dysfunction.
Main Methods:
- Prospective study of 25 patients undergoing upper abdominal surgery.
- LiMAx test, ICG-PDR, and duplex sonography performed preoperatively and on postoperative days (PODs) 1, 3, 5, and 10.
- Daily laboratory and clinical parameters recorded; clinical outcomes assessed at treatment end.
Main Results:
- LiMAx values significantly decreased on POD 1 and increased by POD 3.
- International Normalized Ratio (INR) significantly increased on POD 1.
- Duplex sonography and ICG-PDR indicated hyper-dynamic liver blood flow; no significant differences between laparotomy and laparoscopy groups.
Conclusions:
- Hepatic dysfunction is a significant and often underestimated complication of major abdominal surgery.
- The LiMAx test is an effective tool for quantifying liver dysfunction postoperatively.
- Open and laparoscopic surgery demonstrated comparable effects on liver dysfunction and postoperative SIRS.
