{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:44:01Z","timestamp":1793828641507,"version":"4.6.1"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Laparoscopic cholecystectomy constitutes the current \u201cgold standard\u201d treatment of symptomatic gallstone disease. In order to avoid intraoperative vasculobiliary injuries, it is mandatory to establish the \u201ccritical view of safety\u201d. In cases of poor identification of the cystic duct and artery leading to a missed intraoperative injury, patients present with elevated liver function tests (LFTs) or increased bilirubin postoperatively. The aim of this study is to present a series of patients of our institute with elevated liver enzymes and bilirubin after laparoscopic cholecystectomy in the absence of intraoperative injury or any other obvious etiology and to provide a possible explanation of this finding. Materials and Methods: From 2019 to 2023, 200 patients underwent elective laparoscopic cholecystectomy at the Papageorgiou General Hospital and at the European Interbalkan Medical Center of Thessaloniki utilizing the \u201ccritical view of safety\u201d method. We retrospectively collected the intraoperative reports, and the pre- and postoperative imaging and laboratory studies of the patients included in this series. Postoperative LFTs and bilirubin levels were extracted and the reason for their transient elevation was examined. Results: From 200 cases of laparoscopic cholecystectomy, elevated LFTs and bilirubin were found in six patients on the first postoperative day, which is suggestive of a missed intraoperative injury. All patients were asymptomatic. During the investigatory workup, a triple-phase CT of the liver and\/or an MRCP were ordered, but no pathological findings, such as biliary injury, hepatic artery injury or choledocholithiasis, were found. On postoperative day 3, LFTs and bilirubin levels decreased or normalized without any intervention. No postoperative complications were reported. Conclusions: In select cases, a transient increase in LFTs and\/or bilirubin may be observed in the early postoperative period after elective laparoscopic cholecystectomy in the absence of an obvious etiology. A possible interpretation of these findings could involve the pneumoperitoneum or the anesthesia regimens used intra- or perioperatively. The specific cause, however, remains undetermined and yet to be examined by future studies.<\/jats:p>","DOI":"10.3390\/medicina60111885","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T05:36:45Z","timestamp":1731908205000},"page":"1885","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transient Elevation of Liver Function Tests and Bilirubin Levels After Laparoscopic Cholecystectomy"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3786-4609","authenticated-orcid":false,"given":"Alexandros","family":"Giakoustidis","sequence":"first","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-7009","authenticated-orcid":false,"given":"Menelaos","family":"Papakonstantinou","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3384-1926","authenticated-orcid":false,"given":"Christos","family":"Gkoutzios","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Chatzikomnitsa","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-7804","authenticated-orcid":false,"given":"Areti Danai","family":"Gkaitatzi","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2289-8331","authenticated-orcid":false,"given":"Athanasia","family":"Myriskou","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9637-9972","authenticated-orcid":false,"given":"Petros","family":"Bangeas","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis Dimitrios","family":"Loufopoulos","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-1685","authenticated-orcid":false,"given":"Vasileios N.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6023-4744","authenticated-orcid":false,"given":"Dimitrios","family":"Giakoustidis","sequence":"additional","affiliation":[{"name":"A\u2019 Department of Surgery, General Hospital Papageorgiou, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1016\/j.cgh.2024.01.051","article-title":"Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis","volume":"22","author":"Wang","year":"2024","journal-title":"Clin. 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JGLD"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1885\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:34:06Z","timestamp":1760114046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1885"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,17]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["medicina60111885"],"URL":"https:\/\/doi.org\/10.3390\/medicina60111885","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,17]]}}}