scholarly journals Effect of CO2 Pneumoperitoneum on Liver Function Following Laparoscopic Cholecystectomy

2020 ◽  
Vol 3 (2) ◽  
pp. 17-20
Author(s):  
Rajesh Godara ◽  
Ankur Kajal ◽  
Amit Nehra
Keyword(s):  
Serum Level ◽  
Liver Function ◽  
Liver Enzymes ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Significant Rise ◽  
Normal Serum ◽  
Slight Variation ◽  
Co2 Pneumoperitoneum ◽  
Marked Rise

Background: Laparoscopic provides access to abdominal cavity for both diagnostic and therapeutic surgical interventions which were previously only possible through laparotomy. Recent studies have shown marked rise in serum liver enzymes after laparoscopic surgeries which is considered to be related to the impaired liver and splanchnic perfusion. The present study has been carried out with the aim to comprehend changes in liver enzymes after laparoscopic vs conventional cholecystectomy and the effects of these on outcomes of surgery. Subjects and Methods: Between January 2018 and June 2019, 100 patients with symptomatic gall stones which were eligible for cholecystectomy were enrolled in this prospective clinical observational trial. Randomisation to laparoscopic or open cholecystectomy was performed by using a sealed envelope technique just before surgery. All cases were operated by the same consultant surgeon with a standard anaesthetic protocol. Liver function tests were performed before surgery, at 24 hours and day seven postoperatively. Results: In the laparoscopic group, a statistically significant rise in liver enzymes both aspartate aminotransferase and alanine aminotransferase was observed after 24 hrs of surgery as compared to preoperative values (p<.001) and then again touching normal serum level on 7th day postoperatively. Whereas in open cholecystectomy patients, only a slight variation in the liver enzymes was observed, which was not significant compared to preoperative level (p>.05). No statistically significant changes in serum level of GGT, ALP and bilirubin was seen in either group. No mortality or bile duct injury was observed in this study. Conclusion: Transient elevation in level of liver enzymes occurs after cholecystectomy in both open and laparoscopy group but more in laparoscopic arm attributed to CO2 pneumoperitoneum with possibly some other factors contributing to this. These changes return to normal in a week time after the procedure, and no major complication is generally seen in these patients with normal preoperative liver function, but these temporary derangements at times may be of concern to surgeons for its implication to the integrity of biliary tract.

scholarly journals The Evolving Role of Endoscopic Retrograde Cholangiography before and after Cholecystectomy

1998 ◽  
Vol 12 (3) ◽  
pp. 187-191 ◽  
Author(s):  
SC Ganguli ◽  
TM Pasha ◽  
BT Petersen
Keyword(s):  
Liver Function ◽  
Surgical Approach ◽  
Liver Enzymes ◽  
Open Cholecystectomy ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Period 2 ◽  
Function Test ◽  
Before And After

Laparoscopy is the preferred approach for cholecystectomy; however the indications for pre- versus postoperative endoscopic retrograde cholangiography (ERC) are still evolving. The records of patients who had ERC performed one month before (n=119) or after (n=35) laparoscopic or open cholecystectomy from January 1990 to August 1992 (period 1), and 66 patients who had preoperative ERC from November 1995 to October 1996 (period 2) are reviewed. ERC indications, findings and outcomes were reviewed, and trends in the use of preoperative ERC from 1990 to 1996 were sought. Between periods 1 and 2 the yield of preoperative ERC increased from 36% to 58% (P<0.01). The use of preoperative ERC for the indication of abnormal liver enzymes declined (P<0.05), while the yield increased (25% versus 61%, P<0.01). Both the use of ERC and the yield remained stable for other indications. ERC was felt to have changed the surgical approach in 5% of patients. Primary indications for postoperative ERC (n=35) included abnormal intraoperative cholangiography (43%), liver function test abnormalities (23%) and recurrence of preoperative symptoms (14%); stones were found in 60%, 50% and 20% of patients with these indications, respectively. Overall, 46% of postoperative studies revealed duct stones. The roles for pre- and postoperative ERC are changing and depend greatly on the relative laparoscopic and endoscopic expertise at a given institution.

scholarly journals Reversal of Jaundice in Two Patients with Inoperable Cholangiocarcinoma Treated with Cisplatin and Gemcitabine Combination

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Maarten Criel ◽  
Filip Geurs ◽  
Siegfried Ponette ◽  
Katrien Bulte ◽  
Johan Ponette
Keyword(s):  
Liver Function ◽  
Combination Chemotherapy ◽  
Serum Bilirubin ◽  
Liver Function Tests ◽  
Normal Serum ◽  
Tumor Type ◽  
Chemotherapeutic Approach ◽  
Function Tests ◽  
Severe Jaundice

Two patients are presented with severe jaundice, due to inoperable cholangiocarcinoma. The chemotherapeutic approach in patients with severe jaundice is discussed. Many schedules of chemotherapy were developed in this tumor type with normal serum bilirubin. We report here the first successful use of cisplatin and gemcitabine combination chemotherapy in these patients. Tolerability was good and liver function tests gradually improved.

scholarly journals Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
Author(s):  
R Gabriel ◽  
S Kumar ◽  
A Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Predictive Factors ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Bladder Wall ◽  
Patient Factors ◽  
College Hospital ◽  
Biliary Pain ◽  
Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30     

scholarly journals Vegan Diet Advice Might Benefit Liver Enzymes in Nonalcoholic Fatty Liver Disease: an Open Observational Pilot Study

2021 ◽  
Author(s):  
Giuseppe Chiarioni ◽  
Stefan Lucian Popa ◽  
Andrea Dalbeni ◽  
Carlo Senore ◽  
Daniel Corneliu Leucuta ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver Disease ◽  
Liver Enzymes ◽  
Liver Function Tests ◽  
Vegan Diet ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

Background and Aims: The Western diet is rich in saturated fats, refined sugars and meat consistent with a high-energy load and secondary risk of increased metabolic diseases including nonalcoholic fatty liver disease (NAFLD). However, no data are available on potential benefit of vegan diets in NAFLD and/or nonalcoholic steatohepatitis (NASH). We aimed to study prospectively the effect of a vegan diet, excluding all animal products on liver chemistry in a group of consecutive NAFLD patients. Methods: This was a prospective, pilot study run on 40 consecutive patients affected by NAFLD. Eight subjects refused to join the study for poor diet palatability, leaving 32 patients (19 males, mean age 50 years), with abnormal measures of liver function who agreed to adhere to a vegan diet for six months. The caloric intake was tailored by the dietitian to obtain a weight loss ≥5% of body weight in overweight patients [body-mass index (BMI) ≥25] and ranged from 1500 Kcal to 1800 Kcal. Patients were contacted monthly by phone to reinforce diet and lifestyle advice and were seen at the gastrointestinal clinic when doubtful about diet advice. Results: At six-month follow-up, 6 subjects did not attend the clinic leaving only 26 patients for data analysis. Initial anthropometric values were mean weight 78 kg (range 52-95), mean body mass index (BMI) 26.8 Kg/m2 (range 20.3-31.2). Liver function tests showed mean ALT value 99 U/L (SD±45), mean AST value 54 U/L (SD±44), mean GGT value 160 U/L (SD±122), pre-treatment. After six months mean body weight was 73 Kg (range 52-87), mean BMI was 25.2 Kg/m2 (range 20.3-29.7) (p<0.001 compared to baseline for both parameters). Liver enzymes improved to a mean of ALT value 36 U/L (SD±21), AST value 27 U/L (SD±10) and GGT value 55 U/L (SD±57), respectively (p<0.001 compared to baseline for all enzymes). Normalization of liver function tests as a whole was observed in 20/26 patients (76.9%). A loss of ≥ 5% of body weight was observed in 12 patients (46.1%), but it did not correlate with the normalization of liver function tests (p=0.5). Conclusions: Our data provide preliminary evidence of improved liver enzymes in NAFLD patients with a strict vegan diet and although our study sample is limited, decreased body weight did not seem critical to the outcome.

scholarly journals EFFECT OF ALCOHOLISM ON LIVER FUNCTION TEST IN RURAL POPULATION IN INDIA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Richa K Lath ◽  
Aniruddha Jibhkate
Keyword(s):  
Liver Function ◽  
Liver Function Test ◽  
Liver Damage ◽  
Total Protein ◽  
Liver Enzymes ◽  
Normal Individual ◽  
Public Health Problem ◽  
Albumin Level ◽  
Study Group ◽  
Function Test

Background: alcoholism is one of the major socioeconomic as well as public health problem in India. The problem is occurring equally in urban as well as in rural India. This study was carried out in essence of liver damage in alcoholics and alteration in the biochemical enzymes in the serum with respect to liver damage. Method: 100 alcoholics and 100 non alcoholic patients were selected from the hospital OPD. Liver function test was performed in both the study group. Liver  enzymes ALT,AST,ALP and the total protein and albumin level were compared in  the study group and controls. Results: The results showed there is significant increase in the liver enzymes ALT,AST,ALP in the alcoholic patients as compared to normal individual and significant fall in concentration of the total protein and albumin level in the alcoholics. Keywords: Alcoholics, liver function test

scholarly journals Prognostic Potential of Liver Enzymes in Patients With COVID-19 at the Leishenshan Hospital in Wuhan

2021 ◽  
Vol 11 ◽  
Author(s):  
Zeming Liu ◽  
Di Hu ◽  
Jinpeng Li ◽  
Qing Xia ◽  
Yan Gong ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Enzymes ◽  
Cox Regression ◽  
Liver Function Tests ◽  
Regression Analyses ◽  
Survival Curves ◽  
Severity Of Disease ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Disease Mortality

BackgroundCoronavirus disease 2019 (COVID-19) has evolved into a pandemic. We hypothesized that biochemical indicators of liver function may help determine the prognosis of COVID-19 patients.MethodsPatient information was collected from the Wuhan-Leishenshan hospital. Logistic and Cox regression analyses, Kaplan-Meier curves, and Curve fitting were used to determine the correlation between elevated levels of aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT and severity of disease/mortality.ResultsLogistic and Cox regression analyses and Kaplan-Meier survival curves showed that COVID-19 progression correlated with elevated levels of AST and AST/ALT. The odds ratios for elevated levels of AST and AST/ALT in patients were 0.818 (95% confidence interval [CI]: 0.274-2.441, P = 0.035) and 2.055 (95% CI: 1.269-3.327, P = 0.003), respectively; the hazard ratios were 4.195 (95% CI: 1.219-14.422, P = 0.023) and 3.348 (95% CI: 1.57-7.139, P = 0.002), respectively. The Kaplan-Meier survival curves demonstrated that patients with elevated AST and AST/ALT levels had a higher risk of developing severe COVID-19.ConclusionElevated AST and AST/ALT levels correlated with severity of COVID-19 and mortality. Liver function tests may help clinicians in determining the prognosis of patients undergoing treatment for COVID-19.

scholarly journals Вміст фактора некрозу пухлин α і трансформуючого фактора росту β1 у сироватці крові хворих на гострий апендицит та абдомінальний туберкульоз

2018 ◽  
Author(s):  
V. M. Akimova
Keyword(s):  
Differential Diagnosis ◽  
Immune System ◽  
Serum Level ◽  
Acute Appendicitis ◽  
Inflammatory Process ◽  
Abdominal Cavity ◽  
Abdominal Tuberculosis ◽  
Urgent Problem ◽  
Elisa Method ◽  
Chronic Inflammatory Process

Introduction. Differential diagnosis of acute appendicitis with abdominal tuberculosis is аn urgent problem of medicine. Тhe immune system is involved іn the pathogenesis of diseases, and cytokines are the regulators of inflammation.The aim of the study – to determine the level of cytokines with the pro- and anti-inflammatory potential of TNFα and TGFβ1 and their correlation in the blood of patients with acute appendicitis and abdominal tuberculosis in order to improve diagnosis and treatment tactics. Research Methods. 51 patients with urgent abdominal pathology were examined, 21 of them with phlegmonous form of acute appendicitis, 30 patients with histologically confirmed diagnosis of abdominal tuberculosis. The content of TNFα и ТGFβ1 in serum was examined by the ELISA method by the reagents “Diaclone” and “DRG Diagnostic”.Results and Discussion. The results of studies have shown that the development of acute and chronic inflammatory process in the abdominal cavity is determined by activation of the macrophage-monocytic system, manifested by a significant increase in the serum level of TNFα. It was established that in patients with abdominal tuberculosis on the background of increased serum level of TNFα ((17.57±1.05) vs. (4.97±0.18) pg/ml) the TGFβ1 level does not differ from the control ((16.52±1.15) vs. (17.94±0.71) ng/ml) at that time, as with acute appendicitis, its level decreased ((11.32±0.65) vs. (17.94±0.71) ng/ml). ТGFβ1/TNFα ratio during the abdominal inflammation was much lower than control, but in abdominal tuberculosis in 1.5 times higher than in acute appendicitis.Conclusions. The serum level and ratio of monocyte-macrofage derived TNFα and ТGFβ1 determines the type of inflammation and may be useful in differential diagnostic of acute appendicitis and abdominal tuberculosis.

scholarly journals Silymarin in Combination with Vitamin C, Vitamin E, Coenzyme Q10 and Selenomethionine to Improve Liver Enzymes and Blood Lipid Profile in NAFLD Patients

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 544
Author(s):  
Annalisa Curcio ◽  
Adriana Romano ◽  
Simona Cuozzo ◽  
Antonio Di Nicola ◽  
Orazio Grassi ◽  
...  
Keyword(s):  
Vitamin E ◽  
Liver Function ◽  
Vitamin C ◽  
Coenzyme Q10 ◽  
Liver Enzymes ◽  
Lifestyle Modification ◽  
Tolerability Profile ◽  
Blood Profile ◽  
Alcoholic Fatty Liver ◽  
Glutamyl Transferase

Background and Objectives: Non-Alcoholic Fatty Liver Disease (NAFLD) is an emerging cause of hepatopathy that is showing an increasing trend and where the recommendations of lifestyle modification are often not sufficient. The aim of this study is to evaluate the efficacy and tolerability profile of the association of silymarin, vitamin C, vitamin E, coenzyme Q10 and selenomethionine (Medronys epato®) by analyzing liver enzymes, along with the lipidic profile, as markers of liver function, and ultrasound results in NAFLD patients. Materials and Methods: This study enrolled 81 patients with mild to severe NAFLD, divided into two groups: Group A (N = 41) received two capsules a day of silymarin, vitamin C, vitamin E, coenzyme Q10 and selenomethionine (Medronys epato®), and Group B (N = 40) received only recommendations for lifestyle modification including hypocaloric diet, physical exercise and encouragement for weight loss. Patients have been evaluated at three timepoints: baseline (T0), after 45 days of treatment (T1) and after 90 days of treatment (T2), by collecting blood parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and the lipid blood profile. Ultrasonographic results have been analyzed at T0 and T2, along with the tolerability profile and side effects, registered at time T2. Results: The administration of the association of silymarin, vitamin C, vitamin E, coenzyme Q10 and selenomethionine (Medronys epato®) was effective since it showed a significant reduction of the evaluated parameters of ALT, AST, ALP and GGT, a significant improvement of lipid parameters, evaluated as markers of liver function, and improvements of ultrasonographic results. The use of this formulation at the dosage of two capsules a day has been well tolerated and no adverse events have been reported during study period of three months. Conclusions: The administration of the association of silymarin, vitamin C, vitamin E, coenzyme Q10 and selenomethionine (Medronys epato®) was effective and well tolerated in the improvement of hepatic function of NAFLD patients.

A dose-response and meta-analysis of phytosterols consumption on liver enzymes

2019 ◽  
Vol 50 (3) ◽  
pp. 579-600
Author(s):  
Somayeh Tajik ◽  
Kevan Jacobson ◽  
Sam Talaei ◽  
Hamed Kord-Varkaneh ◽  
Zeinab Noormohammadi ◽  
...  
Keyword(s):  
Liver Function ◽  
Design Methodology ◽  
Liver Enzymes ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Serum Biochemistry ◽  
Effect Sizes ◽  
Random Effects Model ◽  
Weighted Mean ◽  
Content Type

Purpose The results of human studies evaluating the efficacy of plant Phytosterols on liver function were inconsistent. Therefore, the purpose of this paper is to eliminate these controversies about the Phytosterols consumption on liver serum biochemistry in adult subjects. Design/methodology/approach The literatures systematically searched throughout PubMed and Scopus databases up to June 2018; it was conducted by using related keywords. Estimates of effect sizes were expressed based on weighted mean difference (WMD) and 95% CI from the random-effects model (erSimonian and Laird method). Heterogeneity across studies was assessed by using I2 index. Eighteen studies reported the effects of Phytosterols (PS) supplementation on liver serum biochemistry. Findings The current meta-analysis did not show a significant effect on ALT (MD: 0.165 U/L, 95% CI: −1.25, 1.58, p = 0.820), AST (MD: −0.375 IU/Liter, 95% CI: −1.362, 0.612, p = 0.457), ALP (MD: 0.804 cm, 95% CI: −1.757, 3.366, p = 0.538), GGT (MD: 0.431 U/L, 95% CI: −1.803, 2.665, p = 0.706) and LDH (MD: 0.619 U/L, 95% CI: −4.040, 5.277, p = 0.795) following PS consumption. Originality/value The authors found that no protective or toxic effects occur after the consumption of Phytosterols on liver enzymes including ALT, AST, ALP, LDH and GGT.

scholarly journals A májfunkció romlásának rizikófaktorai sikeres vesetranszplantációt követően

2019 ◽  
Vol 160 (5) ◽  
pp. 186-190
Author(s):  
Bernadett Borda ◽  
Attila Nemes ◽  
Csaba Lengyel ◽  
Tamás Várkonyi ◽  
Ferenc Rárosi ◽  
...  
Keyword(s):  
Liver Function ◽  
Immunosuppressive Therapy ◽  
Liver Enzymes ◽  
Graft Loss ◽  
Study Results ◽  
Allograft Function ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Abstract: Introduction: Increase of liver function is one of the most common complications after kidney transplantation due to the use of immunosuppressive therapy and hyperlipidemia in addition to hepatitis C virus (HCV) infection. Method: Following the selection criteria (n = 59), the study is based on applied immunosuppressive therapy, baseline data of patients, further correlation between HCV and liver function deterioration. Patients were subjected to fasting laboratory examination to monitor serum electrolytes, uric acid and albumin levels. We looked at the effects of immunosuppressive therapy on the lipids (TG, TC, HDL, LDL) and liver enzymes (GOT, GPT, ALP, GGT). The analysis of the relationship between lipids and liver enzymes was also included in our study. Results: The data basics were not significantly different between the tacrolimus and the cyclosporine groups. In the laboratory results, Mg levels were significantly different between the two groups (p = 0.044). The impact of HCV on the liver function was significantly different on GGT (p = 0.008). We examed the lipids and liver function level between the tacrolimus and the patients receiving cyclosporine-based immunosuppression and the total cholesterol (p = 0.005) and GOT (p = 0.05) were significantly different between the two groups. Hyperlipidemia was associated with 26% of patients taking tacrolimus-based immunosuppression, and 89% of those receiving cyclosporine; the difference was significant (p = 0.002). Regarding the effect of hyperlipidemia on liver enzymes, ALP (p = 0.006) and GGT (p = 0.0001) were significantly higher. Conclusion: Increases in hepatic enzymes, ALT and GGT indicate the damage to hepatocytes. Beside the increase of liver function, which is the main risk factor in hepatitis on HCV soil, the applied immunosuppressive therapy and hyperlipidemia lead to degradation of allograft function and long-term graft loss. Orv hetil. 2019; 160(5): 186–190.

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