Objective: To determine the effect of pneumoperitoneum on liver indocyanine green (ICG) metabolism and the hepatic blood flow in normal and cirrhotic rats.
Methods: Thirty male Wistar rats were randomized into five groups: normal anaesthesia group, normal laparotomy group, normal pneumoperitoneum group, cirrhosis + anaesthesia group, and cirrhosis + pneumoperitoneum group. Liver cirrhosis was induced in two groups by injecting carbon tetrachloride subcutaneously plus drinking 5% alcohol. ICG clearance tests were performed in all the rats.
Results: The ICG level in the normal laparotomy group (0.662 micro g/ml) was higher than that in the normal anesthesia group (0.645 micro g/ml), but the difference was not significant (P > 0,05). The ICG level in the normal pneumoperitoneum group (0.967 micro g/ml) was significantly higher than that in the normal anesthesia and normal laparotomy groups (P < 0.05). The ICG levels in two cirrhotic groups were significantly higher than those in the other three groups (P < 0.05). The ICG level in the cirrhosis + pneumoperitoneum (1.348 micro g/ml) was significantly higher than that in the cirrhosis + anesthesia group (1.198 micro g/ml) (P < 0.05).
Conclusions: During laparoscopic surgery, pneumoperitoneum could decrease the liver ICG clearance rate and the hepatic blood flow, which are of clinical significance in determining the state of liver cirrhotic.