Transient liver dysfunction after laparoscopic gastrectomy for gastric cancer patients.

INTRODUCTION

The effect of laparoscopic surgery under CO2 pneumoperitoneum on liver function is not clear. The aim of this study was to clarify whether laparoscopy-assisted distal gastrectomy (LADG) is associated with changes in liver function compared with open distal gastrectomy (ODG).

METHODS

A total of 205 patients who underwent LADG (n = 147) or ODG (n = 58) between January 1994 and April 2004 were included in this study. Liver function tests-aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, total bilirubin-were examined before surgery and at 1, 3, and 7 days after surgery. The postoperative clinical course was compared between the two groups.

RESULTS

AST levels on day 1 and ALT levels on days 1 and 3 were significantly higher in the LADG group. Albumin levels showed a marked decrease after operation in both groups, but the level recovered more rapidly in the LADG group than in the ODG group, showing significant differences on days 3 and 7. The total bilirubin levels remained unchanged from baseline. The postoperative complication rate was similar in the two groups, although 3 LADG patients among the 27 patients with liver disease suffered severe enteritis.

CONCLUSIONS

Transient liver dysfunction was documented in patients after laparoscopic gastrectomy under CO2 pneumoperitoneum.