Co ₂ Pneumoperitoneum On Liver Function In Rats With Liver Cirrhosis And Portal Blood Flow And Experimental Study On Effect Of

The experimental study on the influence of CO2 pneumoperitoneuinon portal venous flow and liver function in cirrhotic ratsAbstractWith the advent of minimally invasiving surgery, the spectrum of Laparoscopic operations have been growing wider and the difficulty of them also have been growing. The pathophysiologic effects of pneumoperitoneum on organism have been the focus in this field. Some studies have indicated that the hepatic ischemic and reperfusive injury developed during pneumoperitoneum and the functions of liver were impaired after pneumoperitoneum. The reason for the abdominal compartment syndrom is an important facter for the injury of parenchymatous organ. The researches about the influence of pneumoperitoneum on the respiration, circulation, immunology and the vital abdominal organs are springing up. However, the studies on the influence of pneumoperitoneum on the vital parenchymal organs in the pathological situation were very few and superficial. Cirrhosis is a common chronic liver disease. We replicated cirrhosis rats model and designed two experinments to elucidate the rule and mechanism of pneumoperitoneum in the portal venous blood flow and the liver function of cirrhosis rats. The results are as follows:1.The influence of CO2 pneumoperitoneum with various intra-abdominal pressure on portal venous flow dynamics in cirrhotic rats.In the presence of CO2 pneumoperitoneum with various pressure, MAP, IVP, PVF were detected to comprehend the change of portal venous hemodynamics. In order to observe the difference of changes of portal venous hemodynamics between normal rats and cirrhotic rats, We established control group. Results; The MAP in both groups presented decrease trend with the increasing of pressure, but did not appear remarkable difference compared withthe value at 0kPa (0InInHg). The IVP in both grOops showed increasingtendency with the increase of IAP but didn not 8PPear sighfican difference incomparision to the value at 0kPa (0InmH. The FPP in both grouPs aPPearedprogressively increasing wtth the elevation of IAP At l.33kPa (l0 InmHg)pressure the FPP increased siedcantly in both grouPs comPared ed thevaJue at 0kPa (0mmHg) respectively (P<0.05). The PVF in both grouPs aPpeargradua1y decreasing with the increase of IAP The PW in control grouPdecreased sighficantiy at 2.00 kPa (15mmHg) in comPdrision to the value at0kPa (0 nunHg). 0n the other hand, the PVF in cdriotic rats had beendecreased remarkabl}' at 1.33kPa (l0InInHg) compared with the value at 0kPa(0InmHg) (P<0.05). Their maxbo reducing degree were 16% and 38%,reSPectively The PVR in each groap increased gradually with the increase ofIAP The pressure points which made the PVR aPPear triatic change wereat 2.00 tra (15mInHg) in control grouP and at l.33kPa (l0mmHg) inexperimental grouP resPeCtively We conclude from above results: CO2pneumoperitoneum reduce the PVF in ctriotic rats and the PVF decrease inparallel with the IAP. It is considered that the increase of PVR which is causedby the mechedcal compression of CO, pneumoperitoneuxn on the hePaticparenchyma and portal venous wall e1icits the decrease of PW The otherboortan conclusion is that the leve1 of decrease of PVF in cedotic rats ismore severe than in control group at the same IAP2. The infiuence and the mechamsm of CO, pneumoperitoneum wtth.vanous pressure and duration on liver driction in cedotic rats.We replicated the cedosis rats mode1 and estab1ished different pressureand duration CO= pneumoperitoneurn. Liver function and endotoxin weredetermined at preoperation and on the first day and the seventh day. At thesame time the level of MDA, SOD, NO, NOS in the homogenized liver tissuewere determined. The pathologic changes of liver tissue were observed by HEIIIand imxnunohiStochendny Results: (l) The ALT^ST,LDH increasedsigIilficantly in every exPedriental grouPs. The level of ALT^STLDH inexperiInental grouPs were paral1eIing with elevation of pressure and...