W. Thaler et al., ASSESSMENT OF SPLANCHNIC TISSUE OXYGENATION BY GASTRIC TONOMETRY IN PATIENTS UNDERGOING LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY, British Journal of Surgery, 83(5), 1996, pp. 620-624
This experimental study compared the effects of laparoscopic (n=31) an
d open (n=32) cholecystectomy on gastric intramucosal pH (pH(i)), For
this purpose, pH(i) was measured tonometrically before induction of an
aesthesia, at 30-min intervals during surgery, and 1, 2 and 4 h after
operation in otherwise healthy patients undergoing elective cholecyste
ctomy. Additionally, perioperative arterial pH (pH(a)), arterial carbo
n dioxide tension (P-aco2), intramucosal carbon dioxide tension, arter
ial bicarbonate concentration, end-tidal carbon dioxide pressure (P-Ec
o2), levels of serum lactate, lactate dehydrogenase (LDH) and gamma-gl
utamyl transferase (GGT), haematocrit and arterial blood pressure were
recorded. In the two groups no significantly different changes occurr
ed in pH(i), pH(a), serum lactate concentration or haematocrit at any
of the observation times. P-Eco2 and P-aco2 were significantly raised
during the laparoscopic procedure, whereas levels of LDH and GGT and a
rterial blood pressure rose during and after open cholecystectomy. In
spite of the increased intra-abdominal pressure and the peritoneal car
bon dioxide absorption related to the creation of a pneumoperitoneum,
no decrease in pH(i) was detectable during laparoscopic cholecystectom
y.