The effects of increased intraabdominal pressure during laparoscopic surgery on pancreas

In this study, that is aimed to invastigate the possible effects of increased intraabdominal pressure while doing laparoscopic surgery to the pancreatic endocrine/exocrine functions, oxidative stress situation and histopathological structure. In the study there is three groups which has eight rats have formed. All groups have ventilated with tracheostomy. In control group (Group I) pneumoperitoneum has not formed, pneumoperitoneum has formed for 60 minutes with 6 mmHg intraabdominal pressure in group 2 and 12 mmHg in group 3 and then they have been left for reperfusion for 30 minutes. After the procedure blood samples have taken from each rats from the three groups and serum amylase, insülin and glucagon levels have evaluated. Pancreatic tissue samples have taken from the same points of all rats with median laparotomy. Ischemia-reperfusion damage has showen with acconting the tissue malondialdehyde levels, however histopathologic effect has showen with damage grading and biopsy scorring scales. In this study, there is no important histopathological damage has found in each three groups. When the three groups? tissue malondialdehyde levels have compared there is no statistically significant differance between Group 1 and Group 2, Group 2 and Group 3 (p=0,210, p=0,115), but there is significant differance has found between Group 1 and Group 3 (p= 0,001). When the groups amylase levels are statistically compared; there is no significant differance has found between Group 1 and Group 2, Group 1 and Group 3, Group 2 and Group 3 (p=1,00, p=0,529, p=0,208). When the both three groups insülin levels are compared there is no significant differance has found between Group 1 and Group 2 (p=0,753), however there is significant differance has found both Group 1 and Group 3 and Group 2 and Group 3 (p=0,001, p=0,001). When the both three groups glucagon levels are compared there is no significant differance has found between Group 1 and Group 2 (p=0,753), but there is significant differance has found both Group 1 and Group 3 and Group 2 and Group 3 (p= 0,001, p=0,001). In conclusion of this experimental study, safe laparoscopic interval pressures which are accepted between 6 and 12 mmHg pressures with 60 minutes per a surgery, the damage that has happening in pancreas is increasing proportional a little with the pressure level; nevermore this effects do not produce serious pathological problems. Key Words: Laparoscopy, pancreas, pneumoperitoneum