Effect of Carbon Dioxide Intraperitoneal Insufflation Pressure on Coagulation Status and Laboratory Liver Function Test After Laparoscopic Cholecystectomy

Aims: Intraperitoneal CO۲ insufflation appears to be a risk factor for alterations in coagulation and liver function tests (LFT) following laparoscopic cholecystectomy. Therefore, the present study was conducted with the aim of comparing the effect of low-pressure CO۲ intraperitoneal insufflation (۱۲-۱۵ mmHg), and high-pressure CO۲ intraperitoneal insufflation (۱۶-۲۰ mmHg) on the patient's coagulation status and liver function test after laparoscopic cholecystectomy. Materials & Methods: This randomized clinical trial consisted of ۱۵۰ patients who were candidates for laparoscopic cholecystectomy and referred to Shahid Beheshti and Shahid Jalil Hospitals affiliated with Yasuj University of Medical Sciences, Iran in ۲۰۲۲-۲۰۲۳. They were selected using the convenience sampling method and allocated to two different CO۲ insufflation pressure levels, either ۱۲-۱۵ or ۱۶-۲۰ mmHg by random sampling method (۷۵ patients each). Coagulation profile including prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), bleeding time (BT), and liver function tests such as AST (Aspartate Aminotransferase), ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), total bilirubin (T.bili), and direct bilirubin (D.bili) were measured and recorded in the night before the operation and ۲۴ hours after the operation. The data was analyzed by SPSS ۱۶ (p-value<۰.۰۵). Findings: There was a significant increase in PT (p=۰.۰۳۵), and a decrease in BT (p=۰.۰۰۰۱) in the group with pressure levels of ۱۶-۲۰ compared to ۱۲-۱۵ mmHg after the intervention. Conclusion: The level of intraperitoneal CO۲ insufflation has no effect on coagulation and liver. Therefore, CO۲ pressure of ۱۲-۲۰ can be used safely in laparoscopic cholecystectomy surgeries.

کلیدواژه ها:

Carbon Dioxide ، Insufflation ، Blood Coagulation Factor ، Liver Function Test ، Laparoscopic Cholecystectomy