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Related Experiment Videos

Splanchnic ischemia during laparoscopic cholecystectomy

E Eleftheriadis1, K Kotzampassi, D Botsios

  • 1Department of Surgery, University of Thessaloniki, Greece.

Surgical Endoscopy
|March 1, 1996
PubMed
Summary

Laparoscopic cholecystectomy significantly reduces blood flow to abdominal organs, causing splanchnic ischemia. This condition, characterized by reduced hepatic microcirculation and gastric intramural pH, resolves after surgery.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Hepatology

Background:

  • Elevated intra-abdominal pressure during insufflation can cause hemodynamic disturbances and splanchnic ischemia.
  • Previous experimental studies indicated potential risks associated with gas insufflation in the peritoneal cavity.

Purpose of the Study:

  • To clinically validate experimental findings on hemodynamic disturbances during laparoscopic procedures.
  • To assess the impact of laparoscopic cholecystectomy on hepatic microcirculation and gastric intramural pH in human subjects.

Main Methods:

  • A comparative study involving 16 female patients undergoing either open laparotomy or laparoscopic cholecystectomy.
  • Hepatic microcirculation measured using laser-Doppler technique and gastric intramural pH assessed via tonometric catheter.

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  • Measurements taken during pneumoperitoneum and after abdominal deflation in the laparoscopic group.

    • Main Results:

    • Laparoscopic surgery patients showed significantly reduced hepatic microcirculation (22.21 vs 57.52 PUF) and lower gastric intramural pH (7.15 vs 7.37) compared to controls.
    • Immediately after deflation, hepatic microcirculation increased (22.21 vs 67.49 PUF) and gastric pH normalized.
    • These findings indicate transient hypoperfusion and ischemia during the laparoscopic procedure.

    Conclusions:

    • Laparoscopic cholecystectomy induces a state of hypoperfusion and splanchnic ischemia in abdominal organs.
    • The observed changes in microcirculation and pH suggest a compromised tissue environment during the procedure.
    • Further research is needed to determine the clinical significance of these ischemic events.