Comparison of liver function after laparoscopically assisted and open distal gastrectomies for patients with liver disease

BACKGROUND: Several studies have suggested that carbon dioxide (CO(2)) pneumoperitoneum may have an effect on liver function. This study aimed to compare liver function after laparoscopically assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) for patients with liver disease. METHODS: Between January 2006 and December 2007, the study enrolled 50 patients with EGC and liver disease including 18 liver cirrhosis patients, 3 fatty liver patients (n = 3), and 29 healthy hepatitis B or C virus carriers. Albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase levels as well as the volume of drainage in the LADG (n = 18) and ODG (n = 32) groups were determined to assess liver function. RESULTS: The albumin level on postoperative day 7 was significantly higher in the LADG group (3.5 mg/dl) than in the ODG group (3.1 mg/dl; p = 0.042), and the volume of drainage on postoperative day 2 was significantly lower in the LADG group (154.3 ml) than in the ODG group (403.1 ml; p = 0.013). Diuretics were needed by three patients (16.7%) in the LADG group and six patients (18.7%) in the ODG group for control of ascites (p = 0.587). For the patients with liver cirrhosis, none of the parameters between the two groups were significantly different. CONCLUSION: For gastric cancer patients with chronic liver disease, LADG can be considered a safe surgical procedure showing surgical outcomes comparable with those for ODG.