Assessment of the influence of intra-abdominal pressure on the parameters of liver structure and function in patients undergoing laparoscopic gallbladder surgery

Abstract

Trideset i četiri godine nakon prve laparoskopske holecistektomije (LH), koju je izveo Mühe, LH je postala zlatni standard u lečenju kalkuloze i polipoze žučne kese . Ključni element u laparoskopskoj hirurgiji koji pruža jasnu vidljivost i prostor za sigurnu i efikasnu operaciju je pneumoperitoneum. Pneumoperitoneum sa visokim intraabdominalnim pritiskom može uticati na respiratornu, kardiovaskularnu, hepatičnu i bubrežnu funkciju tokom i nakon laparoskopskih operacija. Mogućnost promena u funkciji jetre izazvane laparoskopskom hirurgijom može se smanjiti skraćivanjem vremena rada i primenom nižeg intraabdominalnog pritiska (IAP). Cilj ove studije je da proceni efekte CO2 pneumoperitoneuma na strukturne i funkcionalne testove jetre tokom i nakon laparoskopske holecistektomije.Thirty-four years after the first laparoscopic cholecystectomy (LC), performed by Mühe, LC has become the gold standard in treating calculose and polyps of the gallbladder (1). The key element in laparoscopic surgery that provides visual clarity and space for safe and effective surgery is pneumoperitoneum (2). High-pressure pneumoperitoneum can effect on respiratory, cardiovascular, hepatic, and renal function during and after laparoscopic operations (2,3). The possibility of changes in hepatic function induced by laparoscopic surgery can be reduced by shortening in operation time and using lower intra-abdominal pressure (IAP) (2,4). The aim of this study is to evaluate the effects of CO2 pneumoperitoneum on structural and functional tests of the liver during and after laparoscopic cholecystectomy