The pressure induced during the pnuemoperitonium in laparoscopic surgery is the main variable in most recent studies. 
Several studies proved that it has a deleterious effect on liver function.The cause of increase in the liver function or what is described as transaminities is considered due to the transient ischeamia and reperfusion injury which occurred as a result of obstruction of hepatic blood flow while pnumoperitoinum is performed. 
In this work the role of corticosteroids, prostaglandin (PGE1) and Adenosine triphosphate (ATP) in protecting against the 
injurious effect of the induced pnuemoperitonium in hamsters have been studied In our study we had 4 groups of animals each of 12 male hamsters . The 1st group was the control group where the animals received no drug. In the 2nd , 3rd and the 4th groups the animals were injected with corticosteroid, PGE1 and ATP respectivly. The animals were subjected to GA general anasthesia and pneumoperitonium was performed up to 14-mmHg pressures for up to 60 minutes . Six hamatsers of each group were sacrificed ½ an hour after release of pneumoperitonium and the remaining six animals after 24 hours . The results of this study showed that transaminites and histopathological cell damage occurred in the controle group.The transaminites and the tissue destruction in hepatocytes were also high in the 2nd group but less than the control group. In the 3rd group the enzymes and histopathological architect were less affected ½ an hr after release of pneumoperitonium, but after 24 hr it showed severe impairment. In the 4th group the transaminites were high and tissue damage were severe compared to other groups. 
Corticosteroids has proven to have a promissing protective function against the excpected deleterious effect of the 
pneumoperitonium on liver . Prostaglandin E1 had a good intial protective effect in the immediate post operative results but after 24 hours it showed no effect at all . In this study ATP did not show any benficial protecting effect on the liver