AI Summary & Key Takeaways
AI InsightAlpha-GST returned to the preoperative value at 24th h after surgery in Group 1 but not in Group 2.Conclusion: We conclude that elderly patients undergoing laparoscopic cholecystectomy have more hepatocellular injury when intraperitoneal pressure is greater than 10 mmHg.
📌 3 Key Takeaways
Abstract
Aim: The relation between age and the effect of laparoscopic cholecystectomy on hepatocellular integrity has not been evaluated. We aimed to compare conventional liver function tests in two groups of adults of differing age undergoing elective laparoscopic cholecystectomy.Materials and Methods: We studied 43 patients divided into two groups according to age: Group 1, age 18-60 years (n=22) and Group 2, over 65 years (n=21). All patients received general anesthesia. CO2 was used to insufflate the peritoneal cavity, and intraperitoneal pressure was maintained at 10-14 mmHg during cholecystectomy. Reverse Trendelenburg position was maintained after CO2 insufflation. Arterial blood was sampled before the induction of anesthesia, at the end of surgery, and 1, 3, 6 and 24h after surgery for determination serum alanine aminotransferase (ALT) aspartate aminotransferase (AST), alpha-glutathione S-transferase (alpha-GST), and gamma-glutamyl transpeptidase (GGT) concentrations.Results: Baseline values of alpha-GST were within normal limits in both groups. Alpha-GST increased significantly in two groups at the end of surgery and at 1st hour after surgery. The increase of alpha-GST in Group 2 was higher than Group 1. Alpha-GST returned to normal values at 3,6 and 24h after surgery in both groups. Alpha-GST returned to the preoperative value at 24th h after surgery in Group 1 but not in Group 2.Conclusion: We conclude that elderly patients undergoing laparoscopic cholecystectomy have more hepatocellular injury when intraperitoneal pressure is greater than 10 mmHg.
Özet
Amaç: Laparaskopik kolesistektominin hepatosellüler yapıya etkisinin yaşla ilgisi bilinmemektedir. Çalışmamızda laparoskopik kolesistektomi planlanan farklı yaş gruplarındaki erişkin olgularda, karaciğer fonksiyon testlerini karşılaştırmayı amaçladık.Gereç ve Yöntem: 43 olgu çalışmaya alındı. Olgular 18-60 yaş (Grup 1, n=22) ve 65 yaş üstü (Grup 2, n=21) olarak iki gruba ayrıldı. Tüm hastalara genel anestezi verildi. Laparoskopiyi kolaylaştırmak için CO2 insuflasyonu kullanıldı ve laparoskopi girişimi süresince intraabdominal basınç 10-14 mmHg arasında tutuldu. CO2 insuflasyonundan sonra ters trendelenburg pozisyonu verildi. Arteriyel kan örneği, alfa gulutatyon S transferaz (alfa-GST), alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), gama glutamil transpeptidaz (GGT) düzeylerini değerlendirmek için anestezi indüksiyonundan önce, cerrahi işlemin sonunda, cerrahi bittikten sonra 1., 3., 6. ve 24. saatte alındı.Bulgular: Alfa-GST konsantrasyonu her iki grupta da cerrahi işlemden önce normal sınırlardaydı. Cerrahi işlemin sonunda ve cerrahiden sonraki 1. saatte iki grupta da anlamlı artış gözlendi (p