Postoperatives Verhalten der Serumcholinesterase und anderer Leberenzyme

Journal/Book: Medizinische Klinik. 1973; 68: 809-815.

Abstract: 83 patients underwent cholecystectomy because of uncomplicated cholelithiasis and/or cholecystitis. Bilirubin, alkaline phosphatase, S. G. O. T., S. G. P. T., glutamate dehydrogenase, and cholinesterase were examined before operation and an the first, third, and eighth day after operation. 32 patients were used as controls. 20 patients received 210 mg Silymarin per day, 31 patients received 420 mg Silymarin per day (Legalon®). S.G.O.T., S.G.P.T., and glutamate dehydrogenase serum values increased after the operation which might be caused by the used narcotics. The enzymatic constellation does not speak for hypoxic or mechanic influences. Halothan in combination with barbiturates most likely is the essential noxa. This reversible result does not diminish the importance of the halothan anesthesia. Basically, S.G.O.T., S.G.P.T., and glutamate dehydrogenase should be determined prior to every operation in order to learn any existent liver damages. Serumcholinesterase also shows a decrease of serum activity when photometric demonstration is used which could be interpreted as a hint to reversible damage of liver cells caused by narcotics and analgetics or their metabolites. Cholinesterase should be determined prior to every operation in order to prevent a breakdown of liver function. Preand postoperative administration of 4 tablets of Legalon® 3 times per day seems to decrease the toxicity of the narcotics. The 29 treated patients did not show any excessive enzym changes in contrary to the controls. The small. number of patients, however, only allows careful interpretation.

Keyword(s): Mariendistel

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