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Related Experiment Videos

Gasless laparoscopy could avoid alterations in hepatic function.

G Giraudo1, R Brachet Contul, M Caccetta

  • 1Department of Surgery, University of Turnin, C.S. A.M. Dogliotti, A6, A10126 Torino, Italy.

Surgical Endoscopy
|October 10, 2001
PubMed
Summary
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The gasless laparoscopic technique causes fewer hepatic function changes than high-pressure pneumoperitoneum. Low-pressure pneumoperitoneum and gasless methods show similar effects on liver function, benefiting patients with hepatic failure.

Area of Science:

  • Hepatology
  • Surgical Innovation
  • Anesthesiology

Background:

  • Previous studies linked pneumoperitoneum duration and level to hepatic function changes during laparoscopy.
  • This study clinically evaluates hepatic function during laparoscopy with and without carbon dioxide (CO(2)) pneumoperitoneum.

Purpose of the Study:

  • To compare the impact of gasless laparoscopy versus carbon dioxide (CO(2)) pneumoperitoneum on hepatic function.
  • To assess the influence of pneumoperitoneum pressure (10 mmHg vs. 14 mmHg) on liver function tests post-laparoscopy.

Main Methods:

  • 93 patients underwent laparoscopic procedures (cholecystectomy or non-hepatobiliary) with normal preoperative liver function.
  • Laparoscopic cholecystectomies were performed using gasless technique (20 patients) or pneumoperitoneum (43 patients) at 10 mmHg or 14 mmHg.

Related Experiment Videos

  • Postoperative liver function tests (AST, ALT, bilirubin, prothrombin time) were measured at 6, 24, 48, and 72 hours.

    • Main Results:

    • All patients showed postoperative changes in hepatic tests, with slow return to normality.
    • Increased AST and ALT levels correlated with pneumoperitoneum duration and pressure.
    • Gasless technique and 10 mmHg pneumoperitoneum resulted in significantly lower serological changes compared to 14 mmHg pneumoperitoneum.

    Conclusions:

    • The gasless technique causes less alteration in hepatic parameters than 14 mmHg pneumoperitoneum.
    • Gasless technique and low-pressure pneumoperitoneum exhibit similar effects on hepatic function.
    • Recommend subcutaneous abdominal wall retractors with low-pressure pneumoperitoneum for patients with severe hepatic failure.