Elevated Liver Enzymes as an Operative Complication of Gastric Bypass Surgery

Abstract

The authors postulate that surgical retractor placement may have caused the patient's acute LFT elevation. Specifically, direct mechanical pressure may result in a transient decrease in hepatic blood-flow.

Retraction Transaminitis: An Inevitable but Benign Complication of Laparoscopic Fundoplication

“…In addition to LC, transient derangement in hepatic function has been noted after other abdominal procedures, including: laparoscopic colectomy [7][8][9]; antireflux surgery [12]; laparoscopic vagotomy [12]; obesity surgery, both laparoscopic [13,14] and open [14]; and open gastric and biliary surgery [15]. Interestingly, Ngyen et al attribute the transaminitis they reported in open obesity surgery to retraction but that seen in laparoscopic surgery to the pneumoperitoneum [14].…”

Cardiac tamponade after robotic hiatal hernia repair from liver sling stitch: Case report of a rare complication and literature review

“…The liver sling stitch was devised to replace fixed mechanical liver retraction in anatomically favorable cases. Conventional liver retractors are associated with pain and scarring from additional incisions, radiographic liver injury, and postoperative transaminitis which is usually self-limited [7] , [14] , [15] , [16] . There are reports of lobar necrosis [17] and cardiac injury [18] due to mechanical retractors, but these are exceedingly rare and none have been reported to be fatal.…”