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Hepatic blood flow and function in elderly patients undergoing laparoscopic cholecystectomy
K Sato1, T Kawamura, R Wakusawa
1Department of Anesthesiology, School of Medicine, Iwate Medical University, Iwate, Japan.
Anesthesia and Analgesia
|April 27, 2000
Summary
Laparoscopic cholecystectomy (LC) may reduce middle hepatic venous blood flow (MHVBF) in elderly patients due to pneumoperitoneum. Recovery of MHVBF is slower in older adults after LC compared to open surgery.
Area of Science:
- Hepatology
- Surgical Innovation
- Geriatric Medicine
Background:
- Laparoscopic cholecystectomy (LC) is a common procedure with benefits like shorter hospital stays.
- Concerns exist regarding potential hepatic function impairment in elderly patients undergoing LC.
- Elevated intraperitoneal pressure during LC may affect liver blood flow.
Purpose of the Study:
- To investigate the impact of pneumoperitoneum during LC on middle hepatic venous blood flow (MHVBF).
- To compare MHVBF changes in elderly versus younger patients undergoing LC.
- To assess MHVBF recovery after LC in elderly patients.
Main Methods:
- Continuous measurement of MHVBF using transesophageal echocardiography.
- Monitoring MHVBF during pneumoperitoneum in LC patients.
- Comparison of MHVBF in elderly patients undergoing LC versus open cholecystectomy.
Main Results:
- MHVBF significantly decreased during high intraperitoneal pressure in LC.
- MHVBF recovery was significantly impaired in elderly patients (65-75 yr) post-LC.
- MHVBF remained stable in elderly patients during open cholecystectomy, unlike in LC.
Conclusions:
- Pneumoperitoneum during LC can impair hepatic blood flow, particularly in elderly patients.
- Elderly patients exhibit reduced recovery of MHVBF after LC compared to younger patients.
- Open cholecystectomy does not show the same adverse effects on MHVBF in elderly patients.