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Comparison of Serum Aminotransferase Between Gas and Gasless Laparoscopy Cholecystectomy

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Carbondioxide (C02) insufflations in laparoscopy with gas will increase intraabdominal pressure that influences the hemodynamic, lungs, and kidneys. One of important hemodynamic changes is temporary reduction of hepatic blood flow because of pneumoperitoneum, Pressure caused by pneumoperitoneum can influence ischemia degree of hepatic cell and cause hepatic enzymes increase. Enzyme that includes in hepatic enzyme is aminotransferase, which consists of: transaminase (AST) or glutamic oxaloacetic transaminase serum and alanine transaminase (AL T) or glutamic pyruvic transaminase serum. Laparoscopy method by lifting abdomen wall (gasless laparoscopy) without C02 insufflations can decrease the damaging effects of high intraabdominal pressure. This research was an experimental research with single blind randomized clinical trial (RCT) plan, with observation of symptomatic cholelithiasis patients who underwent cholecystectomy laparoscopic cholecystectomy with gas or C02 (pneumoperitoneum) or without gas (gasless). Hepatic function tests were then held at 24 hours and 72 hours after operation. Research subjects were symptomatic cholelithiasis patients who fulfilled inclusion and exclusion criteria. Samples needed were 24 people in each group. The independent variable was patients with symptomatic cholelithiasis who underwent cholecystectomy laparoscoped with gas compared to those being cholecystectomy laparoscoped without gas. The dependent variable was aminotransferase enzyme value before operation, and 24, 72 hours postoperation. The data were analyzed using Kolmogorov Smirnov, independent t-test, pair t-test, and Mann Whitney test. It was obtained 21 cases for men (43.75%),27 cases for women (56.25%). The average age of the group laparoscopy with gas was 47.16 ± 10.76 years old and the group laparoscopy without gas was 45.3 ± 11 .48 years old (p > 0,05). The average values of AST and ALT 24 hours postoperation of the group laparoscopy without gas were 21.9 ± 7.6 U/L (increase 24%) and 26.3 ± 5.2 U/L (increase 46%) compared to 65.8 ± 18.4 U/L (increase 206%) and 62.8 ± 14.3 U/L (increase 280%) in the group laparoscopy with gas (p < 0,05). The average values of AST and ALT 72 hours postoperation of the group laparoscopy without gas were 24.7 ±B.3 U/L (increase 33%) and 28.9 ± 7.3 U/L (increase 17%) compared to 71,5 ± 28,6 U!L (increase 250%) and 75.8 ± 16.9 U/L (increase 360%) in the group laparoscopy with gas (p < 0,05). In conclusion, there were significafltlY increases of serum aminotransferase values (AST and AL T) in cholecystectomy laparoscopy with gas compared to in cholecystectomy laparoscopy without gas.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

Journal of the Medical Sciences:42(1)2010:10-15

Penerbit

Yogyakarta : Faculty of Medicine Gadjah Mada Universiti., 2010

Deskripsi Fisik

5p.

Bahasa

English

ISBN/ISSN

0126-1312

Klasifikasi

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Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

CHOLECYSTECTOMY, LAPAROSCOPIC
TRANSAMINASES

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

Lampiran Berkas

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