The Effect of L-Hook Dissection and Scissors Dissection on Liver Injury in Laparoscopic Cholecystectomies

Abstract

Purpose: Laparoscopic cholecystectomy is generally performed with the help of monopolar cautery. We aimed to reveal the effect of monopolar cautery use on liver damage in this study. Method: Data of patients who underwent elective cholecystectomy between January 2016 and April 2020 were collected retrospectively. The patients were divided into two groups according to the surgical technique as hook dissection (HI)) and scissor dissection (SD). The amount of increase in the preoperative and postoperative alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values of the patients was compared between the two groups. Findings: Over 970 patients were included in the study. The changes in pre-post ALT and AST values were statistically significantly different between the HD (n=469) and SD (n=501) groups (p<0.001; p0.001). ALT (26 (-25, 338)) and AST (27 (-23, 444)) changes in the HD method were statistically significantly higher than ALT (11 (-16, 371)) and AST (10.8 (-37, 617)) changes in the SD method. Results: ALT and AST values increase after all laparoscopic cholecystectomies. Although the increase in ALT and AST in the HD patients is statistically significant when compared to the SD group, both methods of laparoscopic cholecystectomy can be safely performed because they do not cause permanent liver injury.