IMPACT OF LIVER SEPARATION ON PATIENTS UNDERGOING BARIATRIC SURGERY: A PROSPECTIVE AND COMPARATIVE STUDY.

Abstract

Objective: To evaluate the impact of liver retraction in patients undergoing bariatric surgery compared to patients undergoing non-bariatric laparoscopic procedures (cholecystectomy, appendectomy, hernioplasty). Methods: 42 patients treated at the Dr. Miguel Pérez Carreño Hospital between January and December 2023 were included; 25 patients made up the bariatric group and 17 the control group. Results: 80.94% were women and 19.05% were men, with a mean age of 40,04 ± 9,48 years in the bariatric group and 36,29 ± 10,66 years in the control group. Bariatric group patients showed a mean BMI of 43,48 ± 6,90 kg/m², significantly higher than the non-bariatric group, which was 29,00 ± 3,12 kg/m² (p = 0,00173). Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were evaluated at three points: preoperative, 72 hours postoperative, and at one month. Postoperative ALT and AST levels in the bariatric surgery group increased significantly compared to the non-bariatric group (p < 0,001), suggesting transient subclinical liver damage associated with surgical manipulation of the liver and oxidative stress. LDH values increased in both groups, but without statistically significant differences. Conclusion: These results underscore the importance of monitoring postoperative hepatic alterations, especially in patients undergoing bariatric surgery. Although the observed changes were transient and subclinical, this study highlights the need for future research to better understand the implications of liver retraction in these interventions.