A Comparative Study of Postoperative Hepatic Function Following Laparoscopic Versus Open Cholecystectomy in The North Coastal Region of Andhra Pradesh

Background: This study investigates postoperative hepatic function alterations following laparoscopic (LC) versus open cholecystectomy (OC) in patients from the North Coastal Region of Andhra Pradesh. Cholecystectomy is a common intervention for symptomatic gallbladder disease, with laparoscopic techniques gaining favor due to their minimally invasive nature, resulting in less postoperative pain and quicker recovery. However, concerns arise regarding the effects of carbon dioxide pneumoperitoneum used in LC, which can increase intra-abdominal pressure and impact hepatic blood flow. Material and Methods: The prospective, observational research involved 66 patients (46 undergoing LC and 20 OC) and assessed changes in liver enzymes (AST, ALT, bilirubin, ALP) at preoperative baseline, postoperative Day 1, and Day 7. Results: showed a significant transient elevation in AST and ALT levels in the LC group post-surgery, peaking on Day 1, with levels returning to baseline values by Day 7. Conversely, the OC group exhibited minimal changes, which lacked statistical significance. No clinically significant hyperbilirubinemia or postoperative complications that could affect liver function were observed in either group, confirming that the transient increases in liver enzymes post-LC do not indicate serious hepatic injury. Overall, the findings suggest that while LC may cause short-term biochemical changes in liver function, these changes are reversible and do not lead to significant clinical outcomes. Conclusion: Laparoscopic cholecystectomy leads to a temporary increase in hepatic transaminases (AST and ALT) for about a week, while bilirubin and alkaline phosphatase levels remain stable. This increase is connected to pneumoperitoneum effects, not liver damage. Further multicenter studies in Andhra Pradesh are required to confirm these findings.

Keywords: Laparoscopic, open cholecystectomy, invasive, hyperbilirubinemia.