High transaminases after gastrectomy for a period of time are usually abnormal, and may be caused by drug-related liver damage, hepatitis, fatty liver and other reasons. 1. Pharmacological liver damage: After gastrectomy, the use of drugs may cause pharmacological liver damage. The inactivation ability of hepatocyte transaminase decreases, and transaminase elevation can occur. 2. Hepatitis: If the patient has hepatitis, the inflammation stimulation will easily lead to the rupture of hepatocytes, resulting in the release of part of the transaminases in the hepatocytes into the blood circulation, which may cause high transaminases. 3. Fatty liver: patients with fatty liver can cause necrosis of liver cells, and the necrotic liver cells will release the internal transaminases into the bloodstream, which can cause transaminase elevation. In addition, gallbladder and pancreas disease, heart disease, autoimmune disease, alcohol consumption and so on may cause transaminase elevation, which needs to be evaluated according to the specific condition and test results to determine the cause of the disease. If the transaminase is elevated after gastrectomy, further examination should be done in a timely manner to clarify the cause of the disease and then actively cooperate with the doctor for treatment.