INTRA-ABDOMINAL PRESSURE AS A MODULATOR OF BIOCHEMICAL INDICATORS OF HEPATIC FUNCTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic cholecystectomy is the standard treatment for gallbladder disease; the carbon dioxide pneumoperitoneum required for the procedure may transiently affect liver function. The aim is to examine the evaluation of the impact of different levels of intra-abdominal pressure (IAP) and ASA score on postoperative liver biochemical parameters. A prospective study included 90 patients divided into three groups according to IAP (13, 14, and 15 mmHg; 30 subjects each), with analysis of preoperative and postoperative parameters of liver function. The groups were comparable in terms of age, sex, and body weight, while differences were observed in the type of inflammation and total protein values. After surgery, changes in several biochemical parameters of liver function were recorded, including an increase in the values ​​of direct bilirubin, AST, ALT, and ALP, as well as a decrease in LDH values. The values ​​of total bilirubin, albumin, and total protein did not show significant postoperative changes. Comparison of the groups according to different values ​​of intra-abdominal pressure did not show significant differences in most of the parameters examined, while a statistically significant difference was observed for LDH between the groups. ASA score was associated with postoperative changes in some biochemical parameters of liver function. Laparoscopic cholecystectomy leads to transient changes in liver biochemical parameters without clinically significant damage, whereby intra-abdominal pressure in the usual range has no significant effect, while the general condition of the patient has a greater role in the postoperative response.