Risk Factors for Postoperative Liver Enzyme Elevation After Laparoscopic Gastrectomy for Gastric Cancer

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Laparoscopic gastrectomy (LG) is increasingly used for gastric cancer.
• Phase III trials suggest LG is associated with higher postoperative liver enzyme elevation (PLEE) than open surgery.
• Identifying risk factors for PLEE after LG is crucial for patient outcomes.

Purpose of the Study:

• To determine the risk factors for postoperative liver enzyme elevation (PLEE) following laparoscopic gastrectomy (LG) for gastric cancer.
• To compare surgical techniques and patient characteristics associated with PLEE.

Main Methods:

• Retrospective analysis of 153 gastric cancer patients undergoing LG.
• Comparison of patient characteristics, liver retraction methods (silicone disc vs. Nathanson liver retractor), and perioperative outcomes.
• Multivariate analysis to identify independent risk factors for PLEE.

Main Results:

• PLEE occurred in 17% of patients.
• Longer operative times and Nathanson liver retractor (NLR) use were associated with PLEE.
• NLR liver retraction and aberrant left hepatic artery (ALHA) ligation were independent risk factors for PLEE.

Conclusions:

• Silicone disc liver retraction is a safer method during LG, reducing PLEE.
• Preserving the aberrant left hepatic artery (ALHA) may help prevent postoperative liver dysfunction.