Retraction transaminitis: an inevitable but benign complication of laparoscopic fundoplication

World J Surg. 2008 Dec;32(12):2650-4. doi: 10.1007/s00268-008-9744-0.

Abstract

Background: Transient transaminitis has been identified following laparoscopic abdominal surgery. However, the importance of posture, duration of surgery, and mechanical retraction in its etiology remain unclear.

Methods: Liver function was assessed preoperatively then at 8, 24, 48 and 72 h following laparoscopic surgery including the following procedures: Nissen fundoplication (LN: n = 10); cholecystectomy (LC: n = 10); inguinal herniorrhaphy (LH: n = 10); and gastrectomy (LG: n = 5).

Results: Aspartate aminotransferase (AST) levels in LN patients exhibited a rapid rise within 8 h, peaking at 48 h before returning toward baseline. In the LN group, AST levels were significantly higher at 8 h and 24 hours compared to all other groups and compared to LG at 48 h and 72 h. At 6-week follow-up all AST levels were normal. No significant differences were seen in other hepatic parameters, and no correlation between AST and duration of operation, gender, or age was identified.

Conclusions: Antireflux surgery is associated with transaminitis related to hepatic retraction, which is independent of patient posture or duration of observation, and it resolves spontaneously with no clinical consequences.

MeSH terms

  • Adult
  • Aged
  • Aspartate Aminotransferases / blood
  • Cholecystectomy / adverse effects
  • Cholecystectomy / instrumentation
  • Cohort Studies
  • Dissection / adverse effects*
  • Dissection / instrumentation
  • Female
  • Fundoplication / adverse effects*
  • Fundoplication / instrumentation
  • Gastrectomy / adverse effects
  • Gastrectomy / instrumentation
  • Gastroesophageal Reflux / enzymology
  • Gastroesophageal Reflux / surgery
  • Hernia, Abdominal / enzymology
  • Hernia, Abdominal / surgery
  • Humans
  • Laparoscopy / adverse effects*
  • Liver Diseases / enzymology
  • Liver Diseases / etiology*
  • Male
  • Middle Aged

Substances

  • Aspartate Aminotransferases