LAPAROSCOPIC CHOLECYSTECTOMY AND TIME-COURSE CHANGES IN RENAL-FUNCTION - THE EFFECT OF THE RETRACTION METHOD ON RENAL-FUNCTION

Background: Recently, the retraction method has been used to reduce in traabdominal pressure (IAP) during laparoscopic surgery. The purpose o f this study was to determine the serial changes in renal function dur ing laparoscopic cholecystectomy (LC) using the retraction method. Met hods: Urine output, effective renal plasma flow (ERPF), and glomerular filtration rate (GFR) were measured serially in seven patients who un derwent LC with 12 mmHg pneumoperitoneum (High-IAP group) and five who underwent LC using the retraction method with 4 mmHg pneumoperitoneum (Low-IAP group). Results: Urine output, ERPF, and GFR were decreased during pneumoperitoneum in the High-IAP group, whereas no significant changes in any of these parameters were observed in the Low-IAP group. Conclusions: Our findings demonstrate that reduction of IAP to 4 mmHg using the retraction method prevents the transient renal dysfunction caused by prolonged 12 mmHg pneumoperitoneum during LC, suggesting tha t the retraction method reduces the risk of perioperative renal dysfun ction during laparoscopic surgery.