Effects of Laparoscopic Cholecystectomy on Serum Alt Levels

Background: Laparoscopic Cholecystectomy (LC) is considered to be the gold standard treatment option for cholelithiasis. Various studies have shown that LC causes elevation in serum levels of certain hepatic enzymes. Objective:The objective of this study was to compare the mean pre-operative levels of serum Alanine Transaminase (ALT) with mean post-operative levels of serum Alanine Transaminase after Laparoscopic Cholecystectomy in tertiary care hospital of Rawalpindi. Materials & methods: This single group experimental study was conducted from January 2017 to March 2017 at Surgical Unit 1 of Holy Family Hospital, Rawalpindi. 44 patients with confirmed diagnosis of cholelithiasis undergoing LC were included. Their pre-op serum ALT levels were investigated. Immediately after LC, serum ALT levels were repeated to determine post-op serum ALT levels. Data was analyzed with SPSS v22 and in addition to descriptive statistics; Wilcoxon Signed Ranks test for paired data was applied at 5% level of significance. Results: After LC, serum ALT levels increased in 82%, decreased in 14% while remained same in 4% of the patients. Post-op Derangement of serum ALT levels (>43u/l) was observed in 50% of the patients, with normal baselines, undergoing LC. Mean Pre-op ALTs observed were 28±10 u/l while mean post-op ALTs were 42±15 u/l. Mean change observed between Pre op and Post op ALTs of patients after LC was 14±12 u/l. There was highly significant difference in mean pre-op and mean post-op serum ALT levels with P value 0.00. Results were statistically extremely significant. No relation between elevation of serum ALT levels and gender could be established (P value 0.103) while derangement of ALT levels (>43u/l) was observed more in male than in female patients. Mean change in ALT levels after LC increased proportionally with age. Conclusion: Significant change was observed in serum levels of ALT which suggests that pneumoperitoneum created during LC causes hepatocellular ischemia leading to cellular injury which might be the cause of elevation in serum ALT level.