Abstract
INTRODUCTION: This study aims to explore if laparoscopic surgery impacts liver function tests (LFTs). This study compares LFT changes following elective biliary and non-biliary laparoscopic procedures to determine if the laparoscopic approach itself, rather than underlying biliary pathology, contributes to these alterations. METHODS: This prospective, observational study (July 2023 to June 2024) included 116 American Society of Anesthetists (ASA) grades I and II patients undergoing laparoscopic procedures with normal preoperative LFTs. Exclusion criteria included pre-existing liver disease or conversion to open surgery. The LFTs (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin) were measured preoperatively, at 24 hours, and 72 hours postoperatively. Statistical analysis included Friedman ANOVA, t-tests, and repeated measures ANOVA to compare LFT changes between groups and assess the effect of surgical duration. RESULTS: A total of 90 patients underwent a biliary procedure, while 26 patients had a non-biliary procedure. Significant postoperative changes in LFTs were observed, with total bilirubin (TB), AST, ALT, ALP, and GGT significantly increasing at 24 hours (p<0.001) before declining at 72 hours. Preoperative TB and GGT were higher in the biliary group (p=0.034 and p=0.023, respectively). The AST was significantly higher at 24 hours for biliary procedures (p <0.001), with a similar level at baseline. Procedure duration showed a significant association with GGT levels at 24 hours only (p=0.031). CONCLUSION: Laparoscopic surgery results in transient derangement of LFTs, peaking at 24 hours postoperatively, irrespective of biliary or non-biliary indication. These findings underscore the importance of recognizing this transient effect and suggest routine intervention based solely on these changes may be unwarranted.