Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Kotake, Y.
Right arrow Articles by Kikuchi, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kotake, Y.
Right arrow Articles by Kikuchi, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, 2001, Vol. 87, No. 5 774-777
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

Subclinical hepatic dysfunction in laparoscopic cholecystectomy and laparoscopic colectomy

Y. Kotake1, J. Takeda1, M. Matsumoto1, M. Tagawa1 and H. Kikuchi3

1Department of Anesthesiology and 3Department of Laboratory Medicine, Keio University, Shinjuku, Tokyo, Japan*Corresponding author: Department of Anesthesiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan

Laparoscopic surgery causes a reduction in hepatic blood flow due to a number of factors, including raised intra-abdominal pressure, the neurohumoral response to surgical stress and the effect of patient position. The clinical significance of the phenomenon is not fully understood. Plasma concentrations of alcohol dehydrogenase (AD) and glutathione S-transferase (GST), which are concentrated in the centrilobular acinus of the liver, sensitively reflect hepatic hypoperfusion, and can be used to monitor reductions in hepatic blood flow. We compared perioperative AD, GST, aspartate aminotransferase (AST, normal range 14–32 IU litre–1) and alanine aminotransferase (ALT, normal range 8–41 U litre–1) concentrations in patients undergoing laparoscopic cholecystectomy or laparoscopic colectomy to study how patient position and surgical manipulation of the liver affect hepatocellular integrity during laparoscopy. There were significant postoperative increases in AD and GST in the cholecystectomy group [mean (SD) peak concentration 10.8 (4.7) U litre–1 and 113 (55) µg litre–1 respectively]. Although the duration of pneumoperitoneum was longer in the colectomy group, there were no comparable perioperative increases in AD and GST in this group [peak concentration 4.0 (4.0) U litre–1 and 33 (35) µg litre–1 respectively]. AST and ALT on the first postoperative day were significantly higher in the laparoscopic cholecystectomy group (41 and 34 U litre–1 respectively) than in the laparoscopic colectomy group (24 and 18 U litre–1; P<0.05 for each). These results indicate that patient position and the effects of surgical manipulation of the liver affect perioperative hepatic perfusion significantly.

Br J Anaesth 2001; 87: 774–6


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 ANGIOLOGYHome page
G. K. Glantzounis, I. Tsimaris, A. D. Tselepis, C. Thomas, D. A. Galaris, and E. C. Tsimoyiannis
Alterations in Plasma Oxidative Stress Markers After Laparoscopic Operations of the Upper and Lower Abdomen
Angiology, July 1, 2005; 56(4): 459 - 465.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.