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[Hepatic blood flow decreases during laparoscopic cholecystectomy]
1Department of Anesthesiology, Iwate Medical School of Medicine, Morioka.
Masui. the Japanese Journal of Anesthesiology
|July 1, 1996
Summary
Laparoscopic cholecystectomy significantly reduces hepatic blood flow due to high pneumoperitoneum pressure. Median hepatic venous blood flow and left portal venous blood flow return to normal after pressure release.
Area of Science:
- Hepatology
- Surgical Anesthesiology
- Medical Imaging
Context:
- Assessing hemodynamic changes during laparoscopic cholecystectomy (LC).
- Evaluating the impact of pneumoperitoneum on liver blood flow.
- Utilizing transesophageal echocardiography (TEE) for continuous blood flow monitoring.
Purpose:
- To continuously measure median hepatic venous blood flow (MHVBF) and left portal venous blood flow (Lt. PVBF) during LC.
- To investigate the relationship between intraperitoneal pressure and hepatic blood flow.
- To understand the effects of anesthesia and pneumoperitoneum on liver circulation.
Summary:
- Thirty-one patients undergoing LC with inhalation and epidural anesthesia were studied.
- MHVBF and Lt. PVBF decreased significantly from baseline (317±61 ml/min and 522±86 ml/min) to 73±22 ml/min and 98±28 ml/min, respectively, during high pneumoperitoneum.
- Blood flow levels recovered upon deflation, suggesting a direct correlation with intraperitoneal pressure.
Impact:
- Demonstrates that increased intraperitoneal pressure during LC substantially impairs hepatic blood flow.
- Highlights the importance of monitoring hemodynamic parameters in liver circulation during laparoscopic surgery.
- Provides insights into the physiological consequences of pneumoperitoneum on visceral blood flow.