Does laparoscopic cholecystectomy influence peri-sinusoidal cell activity?

BACKGROUND/AIMS: To investigate the influence of laparoscopic procedures on perisinusoidal cell function. METHODOLOGY: In 31 patients who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis, the serum levels of beta-N-acetyl hexosaminidas e (beta-NAH) and hyaluronic acid (HA) were measured. Six female patients, w ho underwent other laparoscopic procedures, not involving the hepatobiliary system, served as controls. RESULTS: HA serum levels increased significantly in both study and control groups, while beta-NAH serum levels remained within normal values. Post-ope rative AST and ALT serum levels increased significantly only in the study g roup. No elevation of serum ALP was noted in any of our patients, and post- operative bilirubin levels did not increase in patients with normal pre-ope rative levels. CONCLUSIONS: Laparoscopic procedures caused detectable damage to Kupffer an d endothelial cells as reflected by elevation of post-operative HA serum le vels. The damage to the liver hepatocytes and perisinusoidal cells has no c linical significance and the laparoscopic procedure itself is the probable cause of the Kupffer and endothelial cells damage, while other mechanisms c aused damage to the hepatocytes.