Transient Liver Dysfunction after Laparoscopic Gastrectomy for Gastric Cancer Patients

Abstract

Transient liver dysfunction was documented in patients after laparoscopic gastrectomy under CO2 pneumoperitoneum.

A Protective Technique for Retraction of the Liver During Laparoscopic Gastrectomy for Gastric Adenocarcinoma: Using a Penrose Drain

“…Despite its advantages over conventional open surgery in terms of less postoperative pain, shorter recovery time and improved cosmesis, a transient derangement in liver function has been recognized following various laparoscopic operations. 1,[8][9][10][11]15,16 Our patients showed the evidence of a transient derangement in liver function after laparoscopic gastrectomy, as did patients with gastric adenocarcinoma in the reports by Etoh et al 10 and Morris-Stiff et al 11 Fortunately, serum AST and ALT levels gradually returned to the reference range in most patients with favorable clinical outcomes in all patients. However, minimizing liver dysfunction is important during the early postoperative period because the liver plays a crucial role in recovery from surgical stress and trauma.…”

“…For displacement of the liver, various surgical liver retractors have been usually applied. [10][11][12][13] However, such mechanical retractors can cause focal hepatic injury that may result in hepatocellular damage, consequent postoperative transient rise in aminotransferases. 9,11 Therefore, to reduce postoperative liver dysfunction, a protective technique for retraction to enable visualization of the operative field is desirable.…”

“…[2][3][4][5][6][7] Several authors have investigated other possible risk factors for liver dysfunction associated with laparoscopic surgery, such as inadequate patients position, specific type of procedure, adverse effects of anesthetic agents, division of the aberrant hepatic artery, inadvertent thermal injury during surgery, and liver contusion from a surgical liver retractor. 1,3,[8][9][10][11] The lateral segment of the liver often interferes with the extension of surgical field during surgery for patients with diseases of the upper abdomen. For displacement of the liver, various surgical liver retractors have been usually applied.…”

Liver Retraction Using n-Butyl-2-Cyanoacrylate (NBCA) Glue during Laparoscopic Splenectomy and Azygoportal Disconnection in Cirrhotic Patients

“…Therefore, the left lateral lobe of the liver was pasted to the diaphragm, with an aim to increase the surgical field of view and operating space (Figure 1(c)). NBCA glue would be degraded completely and absorbed after 9 months [20, 21], and there is no need to separate the liver and diaphragm after surgery.…”

Disk suspension method: a novel and safe technique for the retraction of the liver during laparoscopic surgery (with video)

“…Although some liver lifting methods have been reported, obese patients can still experience problems associated with an insufficient operative field, postoperative liver dysfunction, and liver laceration [2][3][4][5][6][7][8][9][10]. Accordingly, we have developed a novel and safe technique for retracting the liver and the falciform ligament simultaneously using a Silicon Disk, snake retractor, and an elastic band.…”