| Splanchnic microcirculatory changes during CO2 laparoscopy. | |
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MedLine Citation:
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PMID: 9100683 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Splanchnic macrocirculatory changes during high-pressure CO2 pneumoperitoneum include a decrease in mesenteric arterial blood flow, and decreased gastric perfusion with a drop in gastric pH in experimental studies. Microcirculatory changes in abdominal organs under clinical conditions with a low pressure CO2 pneumoperitoneum are unknown. STUDY DESIGN: In 18 patients undergoing routine laparoscopy with a CO2 pneumoperitoneum (7 symptomatic cholecystolithiasis, 3 acute cholecystitis, and 8 acute appendicitis) gastric, duodenal, jejunal, colonic, hepatic, and peritoneal blood flow was measured with a custom-made laser Doppler flow probe at an intra-abdominal pressure of 0, 10, and 15 mm Hg. RESULTS: Intra-abdominal pressure elevation from 10 mm Hg to 15 mm Hg significantly decreased the blood flow in the stomach by 40 percent to 54 percent, the jejunum by 32 percent, the colon by 44 percent, the liver by 39 percent, the parietal peritoneum by 60 percent, and the duodenum by 11 percent. Splanchnic blood flow decreased with operative time at a constant intra-arterial pressure (r = 0.88, p < 0.0001). CONCLUSIONS: From our study, we concluded that laparoscopic procedures with a CO2 pneumoperitoneum should be performed at a pressure of 10 mm Hg or lower to avoid splanchnic microcirculatory disturbances. |
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Authors:
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M K Schilling; C Redaelli; L Krähenbühl; C Signer; M W Büchler |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 184 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-04-30 Completed Date: 1997-04-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 378-82 Citation Subset: AIM; IM |
Affiliation:
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Department of Visceral and Transplantation Surgery, University of Bern, Inselspital Bern, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Carbon Dioxide Colon / blood supply Duodenum / blood supply Female Humans Jejunum / blood supply Liver / blood supply Male Microcirculation Middle Aged Peritoneum / blood supply Pneumoperitoneum, Artificial* Pressure Regional Blood Flow Splanchnic Circulation* Stomach / blood supply |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
Erratum In:
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J Am Coll Surg 1997 Oct;185(4):423 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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