الفهرس 
Surgical anatomy of the biliary tractOnly 14 pages are availabe for public view
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Abstract
Laparoscopic cholecystectomy (LC) has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gallbladder diseases. However, it has been noticed that following LC, the serum level of certain liver enzymes rises markedly in patients who had preoperatively normal liver enzyme values.
In this study, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), were investigated preoperatively and 1,7 days postoperatively in patients who had undergone high pressure laparoscopic cholecystectomy (HPLC) and these changes were compared with those occurring after low pressure laparoscopic cholecystectomy (LPLC) with different duration of pneumoperitoneum.
Statistical analysis revealed significant increases in ALT and AST levels in the HPLC group postoperatively. Compared with the LPLC group, 7 days after the procedure, ALT and AST values had returned to normal values in the HPLC group.
The duration of pneumoperitoneum at constant pressure we found that when the duration of operation exceeds 60 minutes, elevations in AST and ALT levels become more significant.
ALT and AST postoperative elevations could mostly be attributed to the negative effects of the CO2 pneumoperitoneum on the hepatic blood flow. Although these changes do not seem to be clinically important, care should be taken before deciding to perform HPLC in patients with hepatic insufficiency.