Changes in Hematological Parameters and Liver Enzymes During Laparoscopic Cholecystectomy

Adam Umair Ashraf Butt,Qasim Ali,Ahsan Sajjad,Ahmad Farooq,Abdur Rehman Malik,Muhammad Sarfraz Khan,Muhammad Anwar,Zuhair Ali Rizvi

doi:10.7759/cureus.13098

Abstract

BackgroundChanges in hematological parameters, such as neutrophils, leukocytes, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume, have been observed during laparoscopic surgeries.ObjectivesThe objectives of this research were to assess the changes in hematological parameters and liver enzymes during laparoscopic cholecystectomy (LC).MethodsThis prospective observational study included patients undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. Patients with comorbidities, including hepatitis, diabetes, and where laparoscopic cholecystectomy was converted to open cholecystectomy, were excluded. Preoperative and postoperative baseline hematological parameters and liver function tests (LFTs) were recorded. Characteristics like age, gender, body mass index (BMI), indication for surgery, duration of surgery, the pressure of pneumoperitoneum, and the duration of hospital stay were noted. A paired sample t-test was applied to assess the difference between the mean pre and postoperative values of different hematological parameters.ResultsIt was observed that hemoglobin (Hb), hematocrit (Hct), platelets, and alkaline phosphatase (ALP) decreased postoperatively. However, mean corpuscular volume (MCV), mean platelet volume (MPV), leukocytes, and alanine transaminase (ALT) increased postoperatively. The difference in mean Hb, MCV, Hct, leukocytes, MPV, and ALT was statistically significant (p<0.05).ConclusionThere were significant changes in the levels of hematological parameters and liver enzymes during LC.

Highlights

Cholelithiasis is a prevalent disease throughout the world, contributing a prevalence of 10%-15% in the western population and 3%-5% in African and Asian populations [1]
The objectives of this research were to assess the changes in hematological parameters and liver enzymes during laparoscopic cholecystectomy (LC)
It was observed that hemoglobin (Hb), hematocrit (Hct), platelets, and alkaline phosphatase (ALP) decreased postoperatively

Summary

Introduction

Cholelithiasis is a prevalent disease throughout the world, contributing a prevalence of 10%-15% in the western population and 3%-5% in African and Asian populations [1]. In Pakistan, a study noted a prevalence of 10.2% for cholelithiasis among participants undergoing ultrasonography [2]. Laparoscopic cholecystectomy (LC), one of the most commonly performed procedures for gallbladder diseases, has replaced open cholecystectomy (OC) since the 1990s and is considered a surgical procedure of choice for the removal of symptomatic gall bladder disease/symptomatic cholelithiasis [3]. The increased pressure of pneumoperitoneum and hypercarbia are associated with changes in hemodynamic parameters during laparoscopic surgeries [4,5,6]. The cost of pneumoperitoneal pressure perioperatively is paid in the form of compressed abdominal vasculature, including inferior vena cava, aorta, splanchnic, hepatic artery, portal veins, and renal vasculature. Decreased hepatic artery and portal venous blood flow result in transient hepatocellular ischemia triggering cellular injury, as a consequence, the serum. Changes in hematological parameters, such as neutrophils, leukocytes, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume, have been observed during laparoscopic surgeries

Objectives

Methods

Conclusion