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Related Experiment Videos

Does splanchnic ischemia occur during laparoscopic cholecystectomy?

M M Ozmen1, A Kessaf Aslar, H T Besler

  • 1Department of Surgery, Ankara Numune Teaching and Research Hospital, Talatpasa Bul., 06100, Ankara, Turkey. mmahir@excite.com

Surgical Endoscopy
|April 3, 2002
PubMed
Summary

Laparoscopic cholecystectomy (LC) does not adversely affect gut perfusion, unlike open cholecystectomy. Nitric oxide (NO) secretion compensates for potential hypoperfusion during LC, preventing harm.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Physiology

Background:

  • Abdominal pressure elevation during surgery can cause splanchnic ischemia.
  • Pathophysiological changes during laparoscopic cholecystectomy (LC) require further investigation.
  • Evaluating markers like nitric oxide (NO), malondialdehyde (MDA), and gastric intramucosal pH (pHi) is crucial.

Purpose of the Study:

  • To assess changes in NO, MDA, and pHi during LC.
  • To determine if splanchnic ischemia occurs during LC.
  • To compare LC with open cholecystectomy (OC) regarding these physiological markers.

Main Methods:

  • Forty patients undergoing cholecystectomy were randomized to LC or OC.
  • Nitric oxide (NO) and malondialdehyde (MDA) concentrations were measured from blood samples.

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  • Gastric intramucosal pH (pHi) and end-tidal carbon dioxide (ETCO2) were monitored.

    • Main Results:

    • LC group showed no significant change in pHi or ETCO2.
    • OC group exhibited a significant decrease in pHi and an increase in ETCO2.
    • NO and MDA levels showed non-significant increases in the LC group, with no changes in the OC group.

    Conclusions:

    • Laparoscopic cholecystectomy (LC) appears to have no adverse effects on gut perfusion.
    • Compensatory mechanisms, possibly involving nitric oxide (NO) secretion, mitigate potential hypoperfusion during LC.
    • Further research is needed to clarify the implications for longer surgical procedures.