Evaluation of the effect of pre-surgical transaminase enzyme disorder on early outcomes of laparoscopic cholecystectomy

Gallbladder removal surgery is performed in two ways: open, or laparoscopic. Compared with open surgery, laparoscopic surgery has a shorter admission period, less cost of treatment, and the patient’s faster return to work and daily activities. This study aims to investigate the effect of the disorder of transaminase enzymes before surgery on laparoscopic cholecystectomy outcomes.
The present study is a cross-sectional analysis conducted during the period of 2015-2016 on all patients with a diagnosis of acute cholecystitis admitted to the surgical ward of Firoozgar Hospital in Tehran. These patients, based on the level of disorder of the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes, were divided into two groups: enzymatic disorder less than 2 times normal and normal, and enzymatic disorder higher than 2 times normal up to a maximum of 10 times normal. Data were collected by the researcher using a checklist containing the variables under study and analyzed in SPSS-22.
The results of the study showed that of 89 patients with acute cholecystitis, 59.6% were female and the rest were male. The mean and standard deviation of the age of the patients was 48.6 ± 18.71. The analytical results showed that there was no significant relationship between elevated liver enzymes SAT and ALT and variables such as incidence of hemorrhage during surgery, change of surgical method (laparoscopic to open), surgical difficulty report by the surgeon, changes in anesthesia after surgery, and duration of hospitalization (P >0.05).
The results of this study showed that laparoscopy is possible for acute cholecystitis, even with the presence of elevated liver enzymes, and it depends largely on the experience of the surgeon and the anatomy of biliary duct.