EFFECTS OF DIFFERENT INTRAPERITONEAL PRESSURE ON LIVER FUNCTION TESTS POST LAPAROSCOPIC CHOLECYSTECTOMY

Background: Laparoscopic cholecystectomy (LC) is the gold standard for treating symptomatic cholelithiasis. However, pneumoperitoneum created during Laparoscopic cholecystectomy, particularly at higher intraperitoneal pressures, may temporarily alter hepatic perfusion, leading to transient elevations in liver function tests (LFTs). Objective: This study aimed to evaluate the effects of varying intraperitoneal pressures—low (10 mmHg), standard (12 mmHg), and high (14 mmHg)—on postoperative LFTs.Methods: A randomized controlled trial was conducted on 150 patients undergoing elective Laparoscopic Cholecystectomy, divided equally into three groups based on intraperitoneal pressure. Preoperative and postoperative LFTs, including total bilirubin, AST, ALT, and ALP, were measured on postoperative days 1 and 7. Statistical analyses were performed using ANOVA and post-hoc Tukey tests. Results: Postoperative day 1 showed a significant rise in LFTs, particularly in the high-pressure group. AST and ALT levels were significantly elevated in the High Pressure Laparoscopic Cholecystectomy (HPLC) group compared to Standard Pressure Laparoscopic Cholecystectomy (SPLC) and Low Pressure Laparoscopic Cholecystectomy (p < 0.001), while bilirubin and ALP also showed similar trends.By day 7,enzyme levels declined across all groups,though values in the HPLC group remained mildly elevated. No long-term hepatic dysfunction was observed. Conclusion: Higher intraperitoneal pressures during LC are associated with greater transient elevations in liver enzymes. Low-pressure pneumoperitoneum (10 mmHg) is a safer alternative with minimal hepatic stress, making it preferable, especially in patients with pre-existing liver conditions.