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

Background: Studies made on a small number of patients have demonstrated significant modifications in liver function tests (LFT) following laparoscopic cholecystectomy. Aim: To assess retrospectively, post-operative LFT in a large group of patients undergoing elective uneventful laparoscopic cholecystectomy. Methods: 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. Results: 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. Conclusions: In contrary to previously published data, we have validated, in light of our broad sampling, that the induction of CO₂ pneumoperitoneum does not cause deranged liver function tests.