Hazem Helmy, A., Abbass, M., farouk Youssef, Y., I. Nafeh, A., Elkhyatt, H., Saleh, A. (2001). THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS. test, 20(1), 381-385. doi: 10.21608/ejsur.2001.376928
Ahmed Hazem Helmy; Mohamed Abbass; Youssef farouk Youssef; Ayman I. Nafeh; H. Elkhyatt; Azza Saleh. "THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS". test, 20, 1, 2001, 381-385. doi: 10.21608/ejsur.2001.376928
Hazem Helmy, A., Abbass, M., farouk Youssef, Y., I. Nafeh, A., Elkhyatt, H., Saleh, A. (2001). 'THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS', test, 20(1), pp. 381-385. doi: 10.21608/ejsur.2001.376928
Hazem Helmy, A., Abbass, M., farouk Youssef, Y., I. Nafeh, A., Elkhyatt, H., Saleh, A. THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS. test, 2001; 20(1): 381-385. doi: 10.21608/ejsur.2001.376928

THE INCREASE OF INTRA-ABDOMINAL PRESSURE AFFECTS LIVER FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN COMPROMISED LIVER PATIENTS

The Egyptian Journal of Surgery
Volume 20, Issue 1, January 2001, Pages 381-385    PDF (148.22 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2001.376928
Authors
Ahmed Hazem Helmy* 1; Mohamed Abbass2; Youssef farouk Youssef3; Ayman I. Nafeh4; H. Elkhyatt4; Azza Saleh4
1Department of Surgery, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.
2Department of Gastroentrology, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.
3Department of hepatology, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.
4Department of clinical Chemistry, Theodore Bilharze Research Institute, Imbaba, Giza, Egypt.
Abstract
The laparascopic Cholecystectomy is the new and accepted procedure for removal of the diseased gall bladder stones.The procedure is standardized and now it is world wide done in department of general surgery. The adverse effects concerning the pneumoperitonium particularly the increase in the intra abdominal pressure and its effect concerning the heamodynamic and ventilatory effects are studied before.The effect of such increase in the intra abdominal pressure on the liver enzymes was reported before. In our study we looked at the liver function before and after 24 hours of doing Cholecystectomy in (76 patients). The Laparoscopic Cholecystectomy group were the IAP was 12-15 mmhg (LAC 43 patients) and Minilaparotomy for Cholecystectomy group ( MLC 33 patients). 
It was found that the liver transaminase enzymes were all affected in all patients “transaminites”. In those who had 
compansated liver function and potentially liver disease i.e. Cirrhotic liver with child A and B due to HCV and HBV who 
under went laparoscopic cholycystectomy the liver functions reasched up to 3 -5 -7 times normal. In the Minilaparotomy for Cholecystectomy the enzymes reached 1.5 times normal in normal liver patients and 7 times normal in the compansated liver patients. 
The increase in the intrabdominal pressure was the variable factor among those two groups. We suggest that the 
pneumoperitonium during laparascopic Cholecystectomy initiated some form of ischeamia and this has lead to Ischeamia Reperfusion Injury that had affected the liver function. 
Keywords
Laparoscopic cholecustectomy; minilaparotomy for cholecystectomy Intra abdominal pressure and Intra abdominal hypertension Liver functions; Liver disease
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