Gastrointestinal transit and stress response after laparoscopic vs conventional distal pancreatectomy in the canine model.
BACKGROUND
Several authors have presented the feasibility of laparoscopic pancreatic surgery. However, the pathophysiological effect of laparoscopic pancreatic surgery is not well known.


METHODS
Ten mongrel dogs were randomly operated for laparoscopic and conventional distal pancreatectomy. Fed state gastrointestinal transit times were assessed using radiopaque markers. To assess surgical stress, we determined serum IL-1 and cortisol.


RESULTS
Postoperative mouth-to-anus transit time in the laparoscopic group was not prolonged while it was significantly prolonged in the conventional group compared with the baseline study, but no significant differences between groups were detected. First defecation was observed significantly earlier in the laparoscopic group. Serum cortisol levels were elevated significantly at 4 h after skin incision in both groups and decreased thereafter. In the laparoscopic group, they returned close to the normal level at 8 h after incision, but were still significantly higher in the conventional group. The level of IL-1 was elevated significantly higher in conventional group at 24 h after the skin incision.


CONCLUSIONS
Thus, we conclude that laparoscopic distal pancreatectomy demonstrated faster recovery of the bowel transit and less stress than conventional distal pancreatectomy in dogs.
Naitoh
T
T
Minimally Invasive Surgery Center, Department of General Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. naitot@surg1.med.tohoku.ac.jp
Garcia-Ruiz
A
A
Vladisavljevic
A
A
Matsuno
S
S
Gagner
M
M
D001003:Anal Canal / Q000378:metabolism; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology*; D006854:Hydrocortisone / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D009055:Mouth / Q000378:metabolism; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods*; D011184:Postoperative Period; D013312:Stress, Physiological / Q000097:blood / Q000503:physiopathology*; D013997:Time Factors
D007375:Interleukin-1; D006854:Hydrocortisone