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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/3120

 
Title :[原著]腹腔鏡下胆嚢摘出術における気腹圧の影響
Title alternative :General Influence of the Pneumoperitoneal Pressure in Laparoscopic Cholecystectomy (LC)
Authors :草野, 敏臣
武藤, 良弘
高江洲, 裕
奥島, 憲彦
山里, 将仁
出口, 宝
玉城, 哲
野原, 正史
本馬, 周淳
徳嶺, 章夫
Authors alternative :Kusano, Toshiomi
Muto, Yoshihiro
Takaesu, Yutaka
Okushima, Norihiko
Yamazato, Masahito
Deguchi, Shigeru
Tamaki, Satoshi
Nohara, Masafumi
Honma, Kaneatsu
Tokumine, Fumio
Authors affiliation :琉球大学医学部第一外科
Issue Date :1993
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346888X
0289-1530
Abstract :The influence due to peumoperitoneum on respilatory and circulatory kinetic during laparoscopic cholecystectomy (LC) was studied. The subjects were 36 cases undergoing LC from February to August 1992. In this study, under anesthesia with neuroleptic analgesia, a muscle relaxant was administered at a sufficient dose; quantitative ventilation was performed at a laghing gas-oxygen ratio of 2:1;and pertial pressure of carbon dioxide (PaCo_2) and arterial keton body ratio (AKBR) during pneumoperitoneum were measured. Of the 36 cases, it was possible to perform LC in 32 cases. In two cases from the early period of the study, one case of suspected biliary calculus dropping, and the other case of cholecystoduodenal fistula. a laparotomy rather than LC was done. Average operation time was 2 hours and 27 minutes. Influence with the pnuemoperitoneum included the temporarily lowered AKBR just after the pneumoperitoneum under anesthesia. However, when AKBR could be kept at a pressure of 10 mmHg or lower, AKBR remained in the safety range. PaCO_2h stayed around 30 mmHg until 180 minutes, when the pressure due to pneumoperitoneum was maintained low, but it was maintained at over 14 mmHg, at 120 minutes later PaC0_2 exceeded 40 mmHg. LC, if maneuvered at a low peumoperitoneum pressre, is a safe operative procedure with a slight negative general influence.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/3120
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.13 no.2 p.167 -171
Appears in Collections:Ryukyu Medical Journal

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