Laparoscopic cholecystectomy and time-course changes in renal function. The effect of the retraction method on renal function.
BACKGROUND
Recently, the retraction method has been used to reduce intraabdominal pressure (IAP) during laparoscopic surgery. The purpose of this study was to determine the serial changes in renal function during laparoscopic cholecystectomy (LC) using the retraction method.


METHODS
Urine output, effective renal plasma flow (ERPF), and glomerular filtration rate (GFR) were measured serially in seven patients who underwent LC with 12 mmHg pneumoperitoneum (High-IAP group) and five who underwent LC using the retraction method with 4 mmHg pneumoperitoneum (Low-IAP group).


RESULTS
Urine output, ERPF, and GFR were decreased during pneumoperitoneum in the High-IAP group, whereas no significant changes in any of these parameters were observed in the Low-IAP group.


CONCLUSIONS
Our findings demonstrate that reduction of IAP to 4 mmHg using the retraction method prevents the transient renal dysfunction caused by prolonged 12 mmHg pneumoperitoneum during LC, suggesting that the retraction method reduces the risk of perioperative renal dysfunction during laparoscopic surgery.
Miki
Y
Y
Department of Surgery, Kinan General Hospital, Wakayama, Japan.
Iwase
K
K
Kamiike
W
W
Taniguchi
E
E
Sakaguchi
K
K
Sumimura
J
J
Matsuda
H
H
Nagai
I
I
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007674:Kidney Diseases / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D017596:Renal Plasma Flow, Effective; D013885:Thiosulfates / Q000097:blood; D014556:Urine; D010130:p-Aminohippuric Acid / Q000097:blood
D013885:Thiosulfates; C017717:sodium thiosulfate; D010130:p-Aminohippuric Acid