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Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy
BACKGROUND: Previously, some studies have proposed that total laparoscopic gastrectomy (TLG) is superior to laparoscopic-assisted gastrectomy (LAG) in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications. However, there...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277945/ https://www.ncbi.nlm.nih.gov/pubmed/37342845 http://dx.doi.org/10.4240/wjgs.v15.i5.859 |
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author | Xiao, Fan Qiu, Xing-Feng You, Cai-Wen Xie, Fu-Ping Cai, Yao-Yuan |
author_facet | Xiao, Fan Qiu, Xing-Feng You, Cai-Wen Xie, Fu-Ping Cai, Yao-Yuan |
author_sort | Xiao, Fan |
collection | PubMed |
description | BACKGROUND: Previously, some studies have proposed that total laparoscopic gastrectomy (TLG) is superior to laparoscopic-assisted gastrectomy (LAG) in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications. However, there are still few studies on the changes in postoperative liver function in patients undergoing LG. The present study compared the postoperative liver function of patients with TLG and LAG, aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients. AIM: To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients. METHODS: The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center (including the Department of Gastrointestinal Surgery and the Department of General Surgery) of Zhongshan Hospital affiliated with Xiamen University, including 40 patients who underwent TLG and 40 patients who underwent LAG. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGLT), total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL), and other liver function-related test indices were compared between the 2 groups before surgery and on the 1(st), 3(rd), and 5(th) d after surgery. RESULTS: The levels of ALT and AST in the 2 groups were significantly increased on the 1(st) to 2(nd) postoperative days compared with those before the operation. The levels of ALT and AST in the TLG group were within the normal range, while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group (P < 0.05). The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range (P < 0.05). The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2, the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4, and the TBIL, DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7 (P < 0.05). No significant difference was observed at other time points (P > 0.05). CONCLUSION: Both TLG and LAG can affect liver function, but the effect of LAG is more serious. The influence of both surgical approaches on liver function is transient and reversible. Although TLG is more difficult to perform, it may be a better choice for patients with gastric cancer combined with liver insufficiency. |
format | Online Article Text |
id | pubmed-10277945 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-102779452023-06-20 Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy Xiao, Fan Qiu, Xing-Feng You, Cai-Wen Xie, Fu-Ping Cai, Yao-Yuan World J Gastrointest Surg Retrospective Study BACKGROUND: Previously, some studies have proposed that total laparoscopic gastrectomy (TLG) is superior to laparoscopic-assisted gastrectomy (LAG) in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications. However, there are still few studies on the changes in postoperative liver function in patients undergoing LG. The present study compared the postoperative liver function of patients with TLG and LAG, aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients. AIM: To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients. METHODS: The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center (including the Department of Gastrointestinal Surgery and the Department of General Surgery) of Zhongshan Hospital affiliated with Xiamen University, including 40 patients who underwent TLG and 40 patients who underwent LAG. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGLT), total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL), and other liver function-related test indices were compared between the 2 groups before surgery and on the 1(st), 3(rd), and 5(th) d after surgery. RESULTS: The levels of ALT and AST in the 2 groups were significantly increased on the 1(st) to 2(nd) postoperative days compared with those before the operation. The levels of ALT and AST in the TLG group were within the normal range, while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group (P < 0.05). The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range (P < 0.05). The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2, the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4, and the TBIL, DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7 (P < 0.05). No significant difference was observed at other time points (P > 0.05). CONCLUSION: Both TLG and LAG can affect liver function, but the effect of LAG is more serious. The influence of both surgical approaches on liver function is transient and reversible. Although TLG is more difficult to perform, it may be a better choice for patients with gastric cancer combined with liver insufficiency. Baishideng Publishing Group Inc 2023-05-27 2023-05-27 /pmc/articles/PMC10277945/ /pubmed/37342845 http://dx.doi.org/10.4240/wjgs.v15.i5.859 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Study Xiao, Fan Qiu, Xing-Feng You, Cai-Wen Xie, Fu-Ping Cai, Yao-Yuan Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title | Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title_full | Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title_fullStr | Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title_full_unstemmed | Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title_short | Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
title_sort | influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277945/ https://www.ncbi.nlm.nih.gov/pubmed/37342845 http://dx.doi.org/10.4240/wjgs.v15.i5.859 |
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