Study On The Correlation Between Central Venous Pressure And Hepatic Venous Pressure In Laparoscopic Hepatectomy

Objective to establish an animal simulation system for laparoscopic hepatectomy and to study changes of central venous pressure and hepatic venous pressure under different conditions in laparoscopic hepatectomy so as to provide a theoretical basis for laparoscopic hepatectomy to reduce bleeding.Methods self-controlled method was used.A simulated laparoscopic hepatectomy system was established in 10 healthy white pigs(weighing 20-30 kg).Right interoal jugular vein was punctured and inserted into right jugular vein,and central venous pressure was measured by electrocardiogram.Left hepatic vein was separated from left hepatic vein and inserted into left hepatic vein.Correlation between hepatic venous pressure and central venous pressure under portal occlusion was compared and analyzed respectively;changes of hepatic venous pressure were analyzed after central venous pressure changes;after pneumoperitoneum pressure changes,changes of blood loss were compared.Result under pneumoperitoneum pressure less than 16mmHg,correlation coefficient between CVP and HVP was 0.365,and there was a high correlation between HVP and CVP in different positions.Time of hepatic portal occlusion was significantly correlated with CVP and HVP,and HVP and CVP were highly correlated with change of central venous pressure.After change of pneumoperitone-um pressure,correlation coefficient between bleeding volume and pneumoperitoneum pressure was-0.648,which was significantly negative correlation,and correlation coefficient with central venous pressure CVP was 0.443,showing a significant positive correlation.Conclusion Laparoscopic liver lobectomy simulation system established in this experiment can simulate real procedure of laparoscopic hepatectomy,especially real experience of blood vessel separation and blood flow control during operation.Central venous pressure was changed by changing pneumoperitoneum pressure,body position,hepatic portal occlusion time and so on.With rise and fall of central venous pressure,hepatic venous pressure showed a good positive correlation with hepatic venous pressure.In laparoscopic hepatectomy,increasing pneumoperitoneum pressure can reduce intraoperative bleeding.