Effects of Capnoperitoneum on Liver Functions: A Comparison Between Biliary and Non-Biliary Laparoscopic Surgeries.

Abstract

Background: Laparoscopic procedures done using capnoperitoneum causes altered enzyme activity, which is subclinical most of time hence goes undiagnosed, leading to life threatening complications in patients with compromised hepatic function. Studies on altered hepatic enzyme activity has been done on patients undergoing laparoscopic cholecystectomy and seldom on laparoscopic non biliary surgeries, which we encounter daily. Hence aim of study was to compare effects of capnoperitoneum on liver functions in biliary and non-biliary surgeries.Methods: This prospective clinical observational study was conducted after obtaining institutional ethical clearance. Study was done on 60 patients undergoing surgeries. They were divided into two groups biliary and non-biliary based on undergoing surgeries. Patients blood sample was collected preoperatively and 24 hours postoperative for accessing liver enzymes. Statistical analysis done using SPSS version 23.  Shapiro- wilk, paired ‘t’and chi- square tests were used to analyse the data. P < 0.05 considered statistically significant.Results: The comparative parameters liver enzymes done pre and post operatively in biliary group total bilirubin, direct bilirubin, alkaline phosphatase, total protein, albumin and in non-biliary group aspartate transaminase, alkaline phosphatase, total protein, albumin were statistically significant.Conclusion: Post operative elevation in liver enzymes was found in both biliary and non biliary surgeries but enzymes specific to liver injury was found in biliary group.