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二氧化碳气腹对急性胰腺炎严重程度的影响:大鼠实验研究

Effect of carbon dioxide pneumoperitoneum on the severity of acute pancreatitis: an experimental study in rats.

作者信息

Yol S, Bostanci E B, Ozogul Y, Zengin N I, Ozel U, Bilgihan A, Akoglu M

机构信息

Department of Gastrointestinal Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.

出版信息

Surg Endosc. 2004 Dec;18(12):1747-51. doi: 10.1007/s00464-004-9099-z. Epub 2004 Oct 26.

Abstract

BACKGROUND

In the management of mild acute biliary pancreatitis, it is generally recommended to perform laparoscopic cholecystectomy after the subsidence of the attack during the same hospital admission. The effect of laparoscopy on abdominal organs has been widely investigated but not in acute pancreatitis. This study used an animal model of mild acute pancreatitis to examine the effects of CO(2) pneumoperitoneum on acute pancreatitis in rats.

METHODS

Mild acute pancreatitis was induced in 30 male Sprague-Dawley rats by surgical ligation of the biliopancreatic duct. After 2 days, animals were assigned to three groups: sham operation (animals were anesthetized for 30 min without undergoing laparotomy), CO(2) pneumoperitoneum (applied for 30 min at a pressure of 12 mmHg), and laparotomy (performed for 30 min, and then the abdomen was closed). Two hours after the surgical procedures, animals were killed and levels of lactate dehydrogenase, aspartate aminotransferase, glucose, urea, hematocrit, and leukocyte count among Ranson's criteria and levels of amylase, lipase, and total bilirubin were measured to determine the severity of acute pancreatitis. Histopathologic examination of the pancreas was done, and malondialdehyde and glutathione levels of the pancreas and lung were determined.

RESULTS

The only significant differences between the groups were in lactate dehydrogenase and aspartate aminotransferase levels, which were significantly higher in the pneumoperitoneum group compared to the sham operation group.

CONCLUSION

CO(2) pneumoperitoneum for 30 min at a pressure of 12 mmHg did not affect the severity of acute pancreatitis induced by ligation of the biliopancreatic duct in rats.

摘要

背景

在轻度急性胆源性胰腺炎的治疗中,一般建议在本次住院期间胰腺炎发作缓解后进行腹腔镜胆囊切除术。腹腔镜对腹部器官的影响已得到广泛研究,但在急性胰腺炎方面尚未有研究。本研究采用轻度急性胰腺炎动物模型,探讨二氧化碳气腹对大鼠急性胰腺炎的影响。

方法

通过手术结扎胆胰管,在30只雄性Sprague-Dawley大鼠中诱发轻度急性胰腺炎。2天后,将动物分为三组:假手术组(动物麻醉30分钟但未进行剖腹手术)、二氧化碳气腹组(在12mmHg压力下施加30分钟)和剖腹手术组(进行30分钟,然后关闭腹腔)。手术操作2小时后,处死动物,测量兰森标准中的乳酸脱氢酶、天冬氨酸转氨酶、葡萄糖、尿素、血细胞比容和白细胞计数水平,以及淀粉酶、脂肪酶和总胆红素水平,以确定急性胰腺炎的严重程度。对胰腺进行组织病理学检查,并测定胰腺和肺组织中的丙二醛和谷胱甘肽水平。

结果

各组之间唯一显著的差异在于乳酸脱氢酶和天冬氨酸转氨酶水平,气腹组的这些水平显著高于假手术组。

结论

在12mmHg压力下进行30分钟的二氧化碳气腹,对大鼠胆胰管结扎诱发的急性胰腺炎严重程度没有影响。

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