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13mmHg 气腹压力下活体猪肝脏的形态学变化。

Morphologic Change of In Vivo Porcine Liver Under 13 mm Hg Pneumoperitoneum Pressure.

机构信息

Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences.

Department of Surgery, Shenzhen Second People's Hospital, Shenzhen.

出版信息

Surg Laparosc Endosc Percutan Tech. 2021 Aug 23;31(6):679-684. doi: 10.1097/SLE.0000000000000973.

Abstract

BACKGROUND

Clinically, the total and residual liver volume must be accurately calculated before major hepatectomy. However, liver volume might be influenced by pneumoperitoneum during surgery. Changes in liver volume change also affect the accuracy of simulation and augmented reality navigation systems, which are commonly first validated in animal models. In this study, the morphologic changes in porcine livers in vivo under 13 mm Hg pneumoperitoneum pressure were investigated.

MATERIALS AND METHODS

Twenty male pigs were scanned with contrast-enhanced computed tomography without pneumoperitoneum and with 13 mm Hg pneumoperitoneum pressure.

RESULTS

The surface area and volume of the liver and the vascular diameter of the aortic lumen, inferior vena cava lumen, and portal vein lumen were measured. There were statistically significant differences in the surface area and volume of the liver (P=0.000), transverse diameter of the portal vein (P=0.038), longitudinal diameter of the inferior vena cava (P=0.033), longitudinal diameter of the portal vein (P=0.036), vascular cross-sectional area of the inferior vena cava (P=0.028), and portal vein (P=0.038) before and after 13 mm Hg pneumoperitoneum pressure.

CONCLUSIONS

This study indicated that the creation of pneumoperitoneum at 13 mm Hg pressure in a porcine causes liver morphologic alterations affecting the area and volume, as well as the diameter of a blood vessel.

摘要

背景

在进行大肝切除术前,必须准确计算肝总量和残肝量。然而,肝体积可能会受到手术中气腹的影响。肝体积的变化也会影响模拟和增强现实导航系统的准确性,这些系统通常首先在动物模型中进行验证。本研究旨在研究 13mmHg 气腹压力下猪活体肝脏的形态变化。

材料和方法

20 只雄性猪在无气腹和 13mmHg 气腹压力下进行增强 CT 扫描。

结果

测量肝的表面积和体积以及主动脉腔、下腔静脉腔和门静脉腔的血管直径。肝的表面积和体积(P=0.000)、门静脉横径(P=0.038)、下腔静脉纵径(P=0.033)、门静脉纵径(P=0.036)、下腔静脉血管截面积(P=0.028)和门静脉(P=0.038)在气腹前后有统计学差异。

结论

本研究表明,在猪模型中建立 13mmHg 压力的气腹会导致肝脏形态发生改变,从而影响肝的面积和体积以及血管的直径。

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