Pneumoperitoneum for laparoscopic cholecystectomy is not associated with compromised splanchnic circulation

Abstract

Objective: To investigate the influence of increased intra-abdominal pressure during pneumoperitoneum on splanchnic circulation. Design: Open study. Setting: University hospital, Sweden. Subjects: Five otherwise healthy patients (mean age of 34 years), undergoing laparoscopic cholecystectomy. Interventions: Arterial and hepatic vein catheterization and simultaneous arterial and hepatic vein blood gas sampling in the awake state, during anaesthesia, after the establishment of pneumoperitoneum (intra-abdominal pressure level 11-13 mmHg) and after 30 and 60 minutes of pneumoperitoneum. Main outcome measures: Hepatic blood flow was estimated by the continuous infusion method and used as a measure of splanchnic blood flow. Splanchnic oxygen consumption was calculated according to the Fick principle. Results and conclusion: Splanchnic blood flow and splanchnic oxygen consumption were not affected by pneumoperitoneum at this level of intra-abdominal pressure.