Elevated intrahepatic pressures and decreased hepatic tissue blood flow prevent gas embolus during limited laparoscopic liver resections.

Journal Article

BACKGROUND: As new techniques are emerging for laparoscopic liver resections, concerns have been raised about the development of gas embolus related to the CO(2) pneumoperitoneum. We hypothesized that elevated intrahepatic vascular pressures and decreased hepatic tissue blood flow (LQB) would prevent gas embolus during laparoscopic liver resections under conventional pneumoperitoneum. METHODS: Intrahepatic vascular pressures and LQB were measured in nine pigs with varying CO(2) pneumoperitoneum. Gas embolus was determined after hepatic incision by monitoring pulmonary arterial pressure (PAP), hepatic venous PCO(2), systemic blood pressure (SBP), and suprahepatic vena cava ultrasound. RESULTS: As the pneumoperitoneum was increased from 0 to 15 mmHg, intrahepatic vascular pressures increased significantly (p < 0.05), while LQB decreased significantly (p < 0.05). A 2.0-cm hepatic incision at 4, 8, 15, and 20mmHg produced no ultrasound evidence of gas embolus and no changes in PAP, SBP, or hepatic venous PCO(2) (p = NS). CONCLUSION: These data suggest that the risk of significant embolus under conventional pneumoperitoneum is minimal during laparoscopic liver resections.

Full Text

Duke Authors

Cited Authors

  • Ricciardi, R; Anwaruddin, S; Schaffer, BK; Quarfordt, SH; Donohue, SE; Wheeler, SM; Gallagher, KA; Callery, MP; Litwin, DE; Meyers, WC

Published Date

  • July 2001

Published In

Volume / Issue

  • 15 / 7

Start / End Page

  • 729 - 733

PubMed ID

  • 11591978

Electronic International Standard Serial Number (EISSN)

  • 1432-2218

International Standard Serial Number (ISSN)

  • 0930-2794

Digital Object Identifier (DOI)

  • 10.1007/s004640000235

Language

  • eng