Document Detail

Alterations in portal vein blood pH, hepatic functions, and hepatic histology in a porcine carbon dioxide pneumoperitoneum model.
MedLine Citation:
PMID:  20054574     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Intra-abdominal high pressure and acidosis by carbon dioxide (CO(2)) pneumoperitoneum is known to affect various organ functions. In this study, changes in liver functions and liver histology were investigated during CO(2) pneumoperitoneum in a large animal model. METHODS: Fourteen white pigs were anesthetized with intubation and controlled ventilation. The pigs in the pneumoperitoneum group (PG) were exposed to CO(2) pneumoperitoneum at an intra-abdominal pressure of 8 mmHg, and those in the open laparotomy group (OG) were subjected to laparotomy. Hemodynamics were measured and liver function tests were performed in the carotid artery and portal vein, and the liver tissue was histologically examined. RESULTS: The blood pressure, PO(2), PCO(2), and pH in the carotid artery did not significantly differ between the groups. In the PG, blood pressure, PO(2), and PCO(2) in the portal vein were elevated while the pH was low. There were no significant differences in the levels of aminotransferases and lactate between the groups. In the PG, the arterial ketone body ratio (AKBR) was low at 90 min and the ICG retention rate was high at 180 min; these values differed significantly compared to those at 0 min. Histological examination revealed liver congestion in the PG and no significant change in the OG. In the PG, the TUNEL assay revealed positive staining in the area with focal lytic changes. CONCLUSIONS: CO(2) pneumoperitoneum at an intra-abdominal pressure of 8 mmHg in a porcine model affected liver functions and caused histological changes in the liver. Although it is uncertain whether these alterations observed in the porcine liver occur in humans as well and whether the alterations are reversible after pneumoperitoneum, it may be necessary to pay attention to liver damage during laparoscopic surgery.
Makoto Yoshida; Satoshi Ikeda; Daisuke Sumitani; Yuji Takakura; Masanori Yoshimitsu; Manabu Shimomura; Midori Noma; Masakazu Tokunaga; Masazumi Okajima; Hideki Ohdan
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Publication Detail:
Type:  Journal Article     Date:  2010-01-07
Journal Detail:
Title:  Surgical endoscopy     Volume:  24     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-22     Completed Date:  2010-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1693-700     Citation Subset:  IM    
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
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MeSH Terms
Acidosis / blood*
Carbon Dioxide / administration & dosage*
Gases / administration & dosage*
Hydrogen-Ion Concentration
Liver / anatomy & histology*,  physiology*
Models, Animal
Pneumoperitoneum, Artificial*
Portal Vein*
Reg. No./Substance:
0/Gases; 124-38-9/Carbon Dioxide

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