Manju Singh

EFFECT OF POSTOPERATIVE LIVER FUNCTION DERANGEMENT ON OUTCOME IN GASTROINTESTINAL PERFORATION PATIENTS: A PROSPECTIVE STUDY OF 100 CASES

Gastrointestinal perforation with generalized peritonitis is still associated with considerable morbidity and mortality. Intra-abdominal infections and septic conditions after surgery are frequently accompanied by cholestasis and postoperative jaundice which further increase morbidity and mortality. The aim of our study was to find out the incidence of postoperative liver function derangement in patients of gastrointestinal perforation admitted in our institute and its effect on outcome of these patients. A prospective study of 100 cases was done, 22% cases showed derangement in liver function which included changes in serum billirubin, Aspartate transaminase (AST), Alanine Transaminase (ALT) and Alkaline Phosphatase levels. Out of 100 patients 82% were males and 18% were females with mean age of 51+10 yrs. Patients with preoperative shock had more incidence of deranged liver function 43% as compared to patient with normal preoperative parameters (p value is <0.05) which is very significant. Mean hospital stay in patients with deranged liver function was 23+12 days as compared to patients with normal liver functions 14+6 days. Complication were high wound infection rate 81%, delayed wound healing 64% and leak 64% in patients with deranged liver function which showed significant association(p value <0.05). Mortality was also high in these patient 27% as compared to 8% in patients with normal liver function. In conclusion post-operative derangement in liver function is associated with advanced age, preoperative shock, and prolonged waiting for surgery which affected the outcome of patients of gastrointestinal perforation and increases their morbidity and mortality.