The effect of intraabdominal pressure increase on the functions of the pancreas during laparoscopic surgery

Introduction: The purpose of this study is to investigate the possible effects of increased intraabdominal pressure during laparoscopic surgery on the endocrine/exocrine functions, oxidative stress status, and histopathological structure of the pancreas. Material and methods: Three groups were constituted with eight rats in each. Group I was the control group. After pneumoperitoneum with CO2 gas was performed for 60 min at 6 mmHg in Group II and 12 mmHg in Group III, they were left to reperfuse for 30 min. Next, amylase, insulin, and glucagon levels were studied from the blood samples. Ischemia-reperfusion injury was evaluated histopathologically in pancreatic tissue samples. The level of malondialdehyde showing tissue was measured by spectrophotometry and homogenization. Results: Compared with the other groups, the mean blood amylase, insulin, and glucagon values in Group III were higher at 18.95 U/L, 2.2 IU/mL, and 1,906.18 pg/mL, respectively, and were statistically significant (p = 0.001). In addition, more hemorrhage (37.5%), congestion (100%), and inflammation (62.5%) were detected in the pancreatic tissue of Group III compared with the other groups. The average tissue malondialdehyde levels (171.39 nM/mg) were higher in Group III than in the other control groups and were statistically significant (p = 0.04). Conclusions: Laparoscopic operations at high pneumoperitoneal pressures can cause ischemia-reperfusion injury to the pancreas because of increased intraabdominal pressure. This damage increases with longer operational time. It is evident that this situation will cause even greater problems with pancreatic diseases. Care should be taken in patient selection and management of laparoscopic surgeries.