| Effect of elevated intra-abdominal pressure on portal vein and superior mesenteric artery blood flow in a rat. | |
| | |
MedLine Citation:
|
PMID: 19281420 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIM: Recent clinical experience suggests that minimal access portoenterostomy (the Kasai procedure) for biliary atresia leads to transplantation sooner, compared to the traditional open approach. It should be emphasized that elevated intra-abdominal pressure (IAP) may reduce hepatic and portal blood flow and thus may cause histologic liver damage. The aim of the present study was to evaluate the effects of IAP on blood flow in the portal vein (PV), compared to the superior mesenteric artery (SMA), and on the systemic mean arterial blood pressure (MABP). MATERIALS AND METHODS: Male Sprague-Dawley rats were anesthetized with intraperitoneal ketamine (90 mg per kg) and xylasine (13 mg per kg). Polyethylene catheters (PE-50) were introduced into the right carotid artery for the measurement of MABP. After a midline laparotomy, the SMA and PV were isolated. Ultrasonic blood-flow probes were placed on the vessels for the continuous measurement of regional blood flow. Two large-caliber percutaneous peripheral intravenous catheters were introduced into the peritoneal cavity for inflation of air and for the measurement of IAP. The time course of MABP and SMA and PV flow as well as the relationship between IAP and SMA and PV flow were determined. RESULTS: Although all three hemodynamic parameters decreased with the increase in the IAP, the most significant changes were observed in PV blood flow. IAP at 3 mm Hg resulted in a 26% decrease in PV flow (P < 0.05), a 19% decrease in SMA flow (P < 0.05), and an 11% decrease in MABP (P < 0.05). IAP at 6 mm Hg caused a two-fold decrease in PV flow (P < 0.05), a 30% decrease in SMA flow (P < 0.05), and a 19% decrease in MABP (P < 0.05). There were no changes in the time course of MABP and PV and SMA flow. PV and SMA flow returned to normal values immediately after abdominal deflation. CONCLUSIONS: Persistent IAP decreased MABP, SMA, and, especially, PV flow by 50%. We speculate that in biliary atresia patients with already present liver dysfunction, decrease in SMA flow and even a greater decrease in PV flow from increased IAP, which occurs during a laparoscopic Kasai procedure, may further compromise liver function. This may be one of the explanations for the progression to earlier transplantation in infants undergoing a laparoscopic Kasai procedure. |
| | |
Authors:
|
Jorge Mogilner; Igor Sukhotnik; Vera Brod; Lili Hayari; Arnold G Coran; Eitan Shiloni; Samuel Eldar; Haim Bitterman |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of laparoendoscopic & advanced surgical techniques. Part A Volume: 19 Suppl 1 ISSN: 1092-6429 ISO Abbreviation: J Laparoendosc Adv Surg Tech A Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-04-17 Completed Date: 2009-12-29 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9706293 Medline TA: J Laparoendosc Adv Surg Tech A Country: United States |
Other Details:
|
Languages: eng Pagination: S59-62 Citation Subset: IM |
Affiliation:
|
Department of Pediatric Surgery, Bnai Zion Medical Center, Israel. olguer@bezeqint.net |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abdominal Cavity
/
physiology* Animals Blood Pressure / physiology Male Mesenteric Arteries / physiology* Portal Vein / physiology* Pressure Rats Rats, Sprague-Dawley Regional Blood Flow / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Long-term functional evaluation of fecal continence after laparoscopic-assisted pull-through for hig...
Next Document: Review of laparoscopic training in pediatric surgery in the United Kingdom.