Effect Of Carbon Dioxide Pneumoperitoneum In Laparoscopy Cholecystectomy On Renal Function In Xining

Objective: To study the effect of CO2 pneumoperitoneum on renal function in patients with laparoscopic cholecystectomy in Xining.Methods: Selection of 60 patients with cholecystolithiasis and cholecystitis treated by operation who live in Xining for a long time(average altitude of 2200m),randomly divided the patients into the laparoscopic group and laparotomy group.Collecting 30 cases of laparoscopic surgery patients(LC group)and 30 cases of control group patients with open surgery(OC group)before and after operation at different time points(postoperative,2h,24 h,48h after operation)of blood and urine samples,including blood urea nitrogen(BUN),serum creatinine,Cystatin-C(Cys-C),serum neutrophil gelatinase associated lipocalin(NGAL),urinary N-acetyl beta-D Glucosaminidase(NAG),urine beta 2 microglobulin.Results: 1.All operations were successfully completed.Group LC was completed under endoscopy without conversing to laparotomy.There was no significant difference in operative time between the two groups(P>0.05).2.OC group and LC group(BUN),blood urea nitrogen,creatinine,urine N-acetyl beta-D Glucosaminidase(NAG),urine beta 2 microglobulin in the group had no difference.Postoperative,2h,24 h,48h after operation compared with the preoperative no difference statistical significance(P>0.05).3.Preoperative OC group and LC group,Cys-C NGAL group had no statistical difference(P>0.05),LC group and OC group Cys-C and NGAL changed significantly after 2 hours,2 hours and 24 hours after operation,Cys-C and NGAL increased significantly,postoperative 2h,24 h compared with the preoperative,the difference was statistically significant(P<0.05).After 2h,group LC and group OC,compared with group OC,the increase of Cys-C and NGAL was more obvious than that in group OC,and the difference was statistically significant(P<0.05).After 48 h,group LC and group OC,Cys-C and NGAL were restored to normal.There was no statistical difference between 48 h and pre operation(P>0.05).Conclusion: 1.No changes in BUN,serum creatinine,urine NAG and urine beta 2 microglobulin were observed in the two groups after operation.2.The increase of blood NGAL and Cys-C was caused by 2h after operation in the two groups,and returned to normal 48 h after operation,but the increase of NGAL and Cys-C in LC group was more obvious than in OC group 2h after operation.3.The CO2 pneumoperitoneum in Xining area is safe and feasible.The serum NGAL and Cys-C can be used as a sensitive biological marker for detecting the early renal function changes in the Xining area.