A QUASI-EXPERIMENTAL STUDY ON THE EFFECT OF UPPER GASTROINTESTINAL SURGERY ON LIVER-FUNCTION TESTS

BACKGROUND/AIMS: To determine the effect of upper gastrointestinal (UG I) surgery on liver function tests, a study was performed at Loghman H akim Hospital, Tehran, Iran. METHODOLOGY: In this quasi-experimental s tudy, 60 patients undergoing UGI operations were compared to 20 patien ts with extra-abdominal surgery. In each case, after obtaining a thoro ugh past medical history and physical exam, 5ml of fasting venous bloo d was drawn pre-operatively on the morning of the operation, and liver function tests (LFTs), namely serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and lactate dehydr ogenase (LDH), were measured. The three tests were repeated on the mor ning of days 2 and 4, post-operatively. Other intra- and post-operativ e parameters were also recorded. Finally, the results were analyzed in all 80 cases using the Student's t-test, Yate's corrected chi-square and Pearson's coefficient of correlation. RESULTS: The operations perf ormed in the case group were biliary tract operations (75%), surgery o n the esophagus and stomach (18.3%) and liver and pancreas operations (6.7%). The control operations consisted of head and neck surgery (45% ), breast and thorax operations (35%) and prostate and testes surgery (20%). The mean duration of general anesthesia in the cases and contro ls was 3.62 and 3.58 hours, respectively, with no statistically signif icant difference. The SGOT level increased 54% in the study cases on d ay 2, which significantly differed with the 9% increase in the control s (p<0.05). In the cases studied, SOFT increased 65% on day 2 and 50% on day 4, with a significant difference compared to the 2% decrease an d 2% increase on days 2 and 4 in the controls (p<0.005 and p<0.02, res pectively). LDH levels also increased 17% on day 2 in the case group w ith a significant difference compared to the 8% increase in controls ( p<0.05). CONCLUSIONS: An increase in the levels of SGOT, SGPT and LDH in the first 4 days following UGI surgery is a common problem which se ems to be due to local trauma to the liver rather than the effect of o ther factors such as anesthetic drugs, the duration of surgery, blood transfusions, hypotension and other underlying conditions.