Elevated intrahepatic pressures and decreased hepatic tissue blood flow prevent gas embolus during limited laparoscopic liver resections.
Journal Article (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
Digital Object Identifier (DOI)
- 10.1007/s004640000235
Language
- eng
Conference Location
- Germany