Document Detail


Hepatic blood flow and function in elderly patients undergoing laparoscopic cholecystectomy.
MedLine Citation:
PMID:  10781479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laparoscopic cholecystectomy (LC) has been widely accepted as an alternative to laparotomy and has many advantages, including short hospital stay and very limited surgical invasion. However, this procedure may impair hepatic function in elderly patients because high pressure is maintained in the peritoneal cavity for an extended period. We observed the effect of pneumoperitoneum on the middle hepatic venous blood flow (MHVBF) in elderly patients undergoing LC. LC patients were anesthesized with inhaled and epidural anesthesia, after which MHVBF was continuously measured by transesophageal echocardiography. MHVBF decreased significantly during a period of high intraperitoneal pressure, and recovery of MHVBF after deflation was significantly lower in elderly patients (65-75 yr), but not in younger patients (24-62 yr). In contrast, MHVBF remained almost constant in elderly patients during open cholecystectomy, and thus was significantly different from that in patients who underwent LC with pneumoperitoneum. Laparoscopic cholecystectomy may impair hepatic function in elderly patients because high pressure is maintained in the peritoneal cavity for an extended period.
Authors:
K Sato; T Kawamura; R Wakusawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  90     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-05-18     Completed Date:  2000-05-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1198-202     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, School of Medicine, Iwate Medical University, Iwate, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aging / physiology*
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Blood Flow Velocity
Cholecystectomy, Laparoscopic*
Echocardiography, Transesophageal
Female
Hepatic Veins / physiology,  ultrasonography
Humans
Liver / physiology*
Liver Circulation*
Male
Middle Aged
Pneumoperitoneum, Artificial / adverse effects
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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