Subclinical Hepatic Dysfunction after Laparoscopic Surgery in Pediatrics

Purpose: The purpose of this study was to investigate the effect of laparoscopic surgery on liver function in children, the possible mechanisms behind such effect and how to avoid such effects. Materials & Methods: Blood samples from 200 children who underwent laparoscopic maneuver for undescended testicle (LMUDT) and 200 children who underwent open maneuver for undescended testicle (OMUDT) were tested for liver function by measuring the level of serum alanine aminotrasferase (ALT) and aspartate aminotrasferase (AST) before the operations and on the first, second and seventh postoperative day. Results: The level of serum ALT and AST increased significantly during the first 48 hours post-operation in LMUDT patients. However, no significant change of the serum liver enzymes was detected in OMUDT children. The difference in change of both ALT and AST levels between LMUDT and OMUDT patients was statistically significant. By the seventh postoperative day, the level of both enzymes returned to normal values in all patients. Conclusion: There is a transient elevation of hepatic transaminases occurred after laparoscopic surgery. The major causative factor seemed to be the CO2 pneumoperitoneum. In most of the laparoscopic surgery in children, the transient elevation of serum liver enzymes showed no apparent clinical implications. However, if preoperative liver function was poor, the classic laparoscopic surgery may not be the best choice for the treatment of patients with certain abdominal diseases.