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Surgical Endoscopy
Published in: Surgical Endoscopy 9/2004

01-09-2004 | Original article

Microcirculation and excretory function of the liver under conditions of carbon dioxide pneumoperitoneum

Authors: I. Leister, P. Schüler, B. Vollmar, L. Füzesi, E. Kahler, H. Becker, P. M. Markus

Published in: Surgical Endoscopy | Issue 9/2004

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Abstract

Background: To date, the effects of increased abdominal pressure, as given during carbon dioxide (CO2) pneumoperitoneum, on hepatic microcirculation and biliary excretion are unknown.
Methods: Using a custom-made peritoneal cavity chamber, we performed intravital microscopy of the left liver lobe under conditions of CO2 pneumoperitoneum in a rat model. In addition, biliary excretion was assessed.
Results: The establishment of a CO2 pneumoperitoneum of 4 or 8 mmHg resulted in sinusoidal perfusion failure that was more pronounced in the periportal regions than in the midzonal and pericentral regions of the liver acinus. Biliary excretion was considerably reduced at an intraabdominal pressure of 8 mmHg. Leukocyte–endothelial cell interactions increased significantly in both hepatic sinusoids and postsinusoidal venules.
Conclusion: Alterations in hepatic microcirculation and liver function must be taken into consideration in any kind of laparoscopic surgery and may be of particular clinical relevance in patients with liver pathology.
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Metadata
Title
Microcirculation and excretory function of the liver under conditions of carbon dioxide pneumoperitoneum
Authors
I. Leister
P. Schüler
B. Vollmar
L. Füzesi
E. Kahler
H. Becker
P. M. Markus
Publication date
01-09-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 9/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-9252-0

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