Polat Coskun, Uyar Hilmi, Başsorgun Ibrahim, Kahraman Ahmet, Ciftcioglu Akif, Arikan Yuksel
Department of Surgery, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
J Laparoendosc Adv Surg Tech A. 2012 Dec;22(10):978-83. doi: 10.1089/lap.2012.0328. Epub 2012 Oct 26.
Over the past decade, laparoscopic techniques have markedly evolved, and it has been shown that minimally invasive surgery can provide a safe, effective, and less traumatic management of various surgical diseases. Additionally, it is well known that pancreatitis itself also produced severe oxidative tissue injury by increasing levels of reactive oxygen species. This study therefore aimed to investigate the effects of pneumoperitoneum on the severity of pancreatitis in a rat model of acute pancreatitis induced by cerulein.
Thirty-five Wistar albino rats were divided into five groups with seven rats in each. Experimental pancreatitis was induced using intraperitoneal injection of cerulein. The first group received open laparotomy. Groups 2-5 were treated with 5, 10, 15, and 20 mm Hg, respectively, achieved by applying pressure and waiting for 60 minutes. After this waiting interval, all of the rats were sacrificed; blood samples were taken by intracardiac puncture for biochemical assays, and pancreatic tissue samples were taken for light microscope analysis. Histopathology was scored according to edema, granulation, polymorphonuclear leukocytes, and mononuclear cells in all groups.
Great increases in malondialdehyde and reduced glutathione levels were seen in all of the groups in which pancreatitis was induced. In Group 2-5, more significant increases were detected than in the open laparotomy group (P<.005). In the histopathological examination, Groups 2-5 showed more inflammatory cell infiltration, edema, and granulation tissue than the open laparotomy group (P<.005).
It is useful to remember the parameters of the medical treatment of pancreatitis. While surgical treatment is being decided, we think that the process of all kinds of surgery, including laparoscopic surgery, can increase the severity of pancreatitis.
在过去十年中，腹腔镜技术有了显著发展，并且已经表明微创手术能够为各种外科疾病提供安全、有效且创伤较小的治疗。此外，众所周知，胰腺炎本身也会通过增加活性氧水平而产生严重的氧化组织损伤。因此，本研究旨在探讨气腹对由蛙皮素诱导的急性胰腺炎大鼠模型中胰腺炎严重程度的影响。
35只Wistar白化大鼠被分为五组，每组7只。通过腹腔注射蛙皮素诱导实验性胰腺炎。第一组接受开腹手术。第2 - 5组分别用5、10、15和20毫米汞柱的压力进行处理，通过施加压力并等待60分钟来实现。在这个等待间隔之后，所有大鼠被处死；通过心脏穿刺采集血样进行生化分析，并采集胰腺组织样本进行光学显微镜分析。根据所有组中的水肿、肉芽组织、多形核白细胞和单核细胞对组织病理学进行评分。
在所有诱导了胰腺炎的组中均观察到丙二醛和还原型谷胱甘肽水平大幅升高。在第2 - 5组中，检测到的升高比开腹手术组更显著（P <.005）。在组织病理学检查中，第2 - 5组比开腹手术组表现出更多的炎性细胞浸润、水肿和肉芽组织（P <.005）。
记住胰腺炎的医学治疗参数是有用的。在决定手术治疗时，我们认为包括腹腔镜手术在内的各种手术过程都可能增加胰腺炎的严重程度。
