ArticleWorld journal of surgery2011
Elevation of liver function tests after laparoscopic gastrectomy using a Nathanson liver retractor.
Article in World journal of surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Pooled it
- Crural stitch technique for liver retraction in laparoscopic upper gastrointestinal surgery: a retrospective case series.BMC surgery · 2025Article
- Innovative Left Liver Mobilization for Hiatal Exposure: Advancing Bariatric Surgery Despite Unresolved Safety Questions.Obesity surgery · 2025Article
- Mobilization of the Left Liver for Optimal Hiatal Exposure During Bariatric Surgery Procedures.Obesity surgery · 2025Article
- A Comparative Analysis of the Liver Retraction with Long Surgical Gauze in Three-Port Sleeve Gastrectomy and the Four-Port Nathanson Retractor Technique.Obesity surgery · 2025Article
- Evaluating liver function test alterations in laparoscopic right adrenalectomy with different retractors.Northern clinics of Istanbul · 2025Article
- A case-series study of hepatic left lateral segment inversion for surgical field exposure in laparoscopic gastrectomy.BMC surgery · 2024Article
- Risk factors for liver dysfunction and their clinical importance after gastric cancer surgery.Scientific reports · 2024Article
- Article
- A sandwiching method that simplifies hepatic left lateral segment inversion to secure an optimal surgical view around the esophageal hiatus in laparoscopic and robotic gastrectomy for upper gastric and esophagogastric junction cancers.Langenbeck's archives of surgery · 2023Article
- Liver retraction using an L-shaped retractor during sleeve gastrectomy.Surgery today · 2022Article
- Comparison of the Pretzelflex Retractor and Nathanson Retractor in Laparoscopic Sleeve Gastrectomy Surgery.Obesity surgery · 2021Article
- K-Wire Retractor, a Trocar-Free Liver Retraction Technique in Bariatric Surgery.Obesity surgery · 2021Article
- The Hepatic Left Lateral Segment Inverting Method Offering a Wider Operative Field of View During Laparoscopic Proximal Gastrectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- A Novel Technique to Predict Liver Damage After Laparoscopic Gastrectomy From the Stomach Volume Overlapping the Liver by Preoperative Computed Tomography.World journal of surgery · 2020Article
- Novel use of the Nathanson liver retractor to prevent postoperative transient liver dysfunction during laparoscopic gastrectomy.Asian journal of endoscopic surgery · 2020Article
- Comparison of Two Types of Liver Retractors in Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity.Obesity surgery · 2020Article
- Comparison of a Novel, Trocar-Free Internal Liver Retractor to Standard Liver Retraction in Bariatric Surgery.Obesity surgery · 2019Article
- A novel liver retraction method in laparoscopic gastrectomy for gastric cancer.Surgical endoscopy · 2019Article
- Penrose drain guided insertion of a laparoscopic Nathanson liver retractor.Annals of the Royal College of Surgeons of England · 2015Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough pneumoperitoneum has been suspected as a possible cause of transient elevation of liver function tests (LFTs) after laparoscopic surgery, liver damage by direct retraction could also influence postoperative LFTs. The aim of this study was to clarify whether laparoscopic gastrectomy (LG) using a Nathanson retractor was associated with the postoperative elevation of LFTs compared with open gastrectomy (OG).
methodsA retrospective cohort study of 199 LG and 120 OG patients was conducted. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin were measured before operation and at postoperative days 1, 3, and 7. Abnormal elevation of LFTs was defined as a grade 2 or greater elevation in any parameter. To assess the possible effect of pneumoperitoneum, patients who underwent laparoscopic (n = 324) and open (n = 56) colectomy for colorectal cancer were also compared.
resultsIn both LG and OG groups, LFTs were significantly elevated postoperatively compared with baseline values. Mean ALT and total bilirubin levels on days 1, 3, and 7 were significantly higher in the LG than OG group. Abnormal elevation of LFTs was more frequent in the LG than OG group (50 vs. 12%). In multivariate analysis, LG was significantly associated with postoperative liver dysfunction (odds ratio [OR] = 7.99; 95% confidence interval [95% CI] = 3.69-18.85). No significant difference in the elevation of the LFTs was observed between laparoscopic and open colectomy (6% and 9%, respectively).
conclusionsLG resulted in frequent elevation of LFTs. Care should be taken to minimize intraoperative liver damage when performing LG using a Nathanson retractor.
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