Liver function test correlation with insufflation pressure of 12 to 15mmhg of co2 pneumoperitoneum following laparoscopic cholecystectomy

Background: Although laparoscopy offered many advantages over laparotomy,some concerns arose over time regarding the effects of a pneumoperitoneum CO2 on liver function. The pressures of created pneumoperitoneum and its duration influences the degree of hepatic ischemia by causing elevations in liver enzymes. We aimed to investigate the effects of different insufflation pressures of CO2 pneumoperitoneum on Liver function tests following laparoscopic cholecystectomy.
Method: We randomly selected 100 patients with no other co –morbidities who were posted for laproscopic-cholecystectomy from ESIC MC PGIMSR, for this prospective study, with normal LFT preoperatively then divided into 3 groups,A,B,C where 3 different insufflation pressures used from 12 mmhg to 15mmhg. Further each group subdivided based on duration of surgery as subgroup1 with<30mins, subgroup2 with 30-90minutes, subgroup3 with 90-135 minutes and subgroup4 with>135mins.LFT(TB,DB,SGOT,SGPT) changes been studied and compared among all these groups pre and post operatively
Results: The study was based on paired t test with sig 2 tailed. The effect of Co2 on individual liver enzymes were studied in 100 Patients(n=100).Comparing Pre and post-operative TB in group 1 and subgroup 1,2,3 show p value (p=0.55),(p=0.66),(p=0.84) respectively and was insignificant.Similarly other groups and subgroups showed insignificant p value in other studied parameters as in DB, SGOT,SGPT.
Conclusion: Co2 insufflation pressure from 12-15 mmhg  under studied duration has no significant effects on liver enzyme rise postoperatively. Thus CO2 is safe in creating pneumoperitoneum as in the studied pressures and duration for laparoscopic cholecystectomy