THE INFLUENCE OF INCREASED INTRAABDOMINAL PRESSURE ON BLOOD-COAGULATION VALUES

AIMS/BACKGROUND: Increased intra-abdominal pressure during laparoscopi c cholecystectomy changes pressure values in the thoracic cavity, in b lood vessels, and in biochemical blood values. METHODOLOGY: In this pr ospective study, we investigate whether CO2 pneumoperitoneum causes bl ood absorption and whether there is an increased risk of thromboemboli sm because of its mechanical influence on reographic and biochemical b lood attributes. We analyzed pH, BE and arterial blood pCO(2) pre-oper atively, three times during surgery and post-operatively; and blood co agulation values pre-, during and 30 minutes after the operation. Bloo d samples were taken from 75 patients, divided into two groups. The fi rst group consisted of 50 patients on whom laparoscopic cholecystectom ies were performed, while the second (control) group consisted of 25 p atients who were operated on by open laparotomy. All patients had a pr e-operative physical status of ASA I and ASA II. RESULTS: There was no statistically significant difference in pCO(2) in any measurement, bu t in the group of patients treated with a laparoscopy there were stati stically significant increases in pCO(2) in three measurements during the operation. CONCLUSIONS: The data show that during the laparoscopy the pneumoperitoneum had no physical or biochemical influence on coagu lation values and so reduced the risk of thromboembolism.