Document Type : Research Paper

Authors

Department of Surgery and Obstetrics, University of Baghdad, Baghdad, Iraq

Abstract

The present study was designed to evaluate the feasibility and safety of laparoscopic partial hepatectomy via two techniques in rams. Twenty-four adult local breed rams were used, which divided randomly and equally into two groups. All animals subjected to laparoscopic partial hepatectomy. operations were performed under the effect of general anesthesia by using 5% thiopental sodium at a dose rate of 15 mg/kg B.W., intravenously and maintenance was done by inhalation (halothane) (2- 2.5%). Animals placed in a reverse Trendelenburg (30º) and left lateral position. Pneumoperitoneum was achieved under (10 - 12mmHg). Four (10 mm) ports were made on ventral abdominal wall. Liver parenchyma was controlled with modified liver clamp. In first group, partial hepatectomy was done by Clamp-crush forceps. While in second group, Ultra- surgical device was used. Following operations, certain parameters such as rectal temperature, respiratory rate, heart rate, food intake, and secondary health problemes had been recorded. Also the operative and resection times and blood loss were estimated. Liver enzymes (alinine transaminase, aspartate transaminase, alkaline phosphate, total serum bilirubin and total serum proteinswere measured. Histopathological examination of liver biobsies was performed at 3rd, 7th, 15th days and four months post-surgery. The main intra-operative complication was the bleeding. Result indicated that the vital parameters were within the normal rang. Shorter operative and resection times were noticed in second group when compared with first group. There were no significant differences in the mean values of blood loss in both groups. Also no bile collection were seen in the abdominal cavity or subphrinic region during the exploratory laparoscopy at (3, 7, and 15 days) and four months post-surgery. There were no significant differences in the mean values of the liver function test (liver enzymes) in two groups. Macroscopic examination revealed the presence of adhestion between liver and adjcent structures with varing degree. The normal structures of the liver which consist of hepatocytes and central vein returned within 4 months post operations in second group. We can conclude that the laparoscopic partial hepatectomy in rams can be safely performed under Ultra-surgical technique with a modified liver clamp which reflected minor secondary complications and early liver regeneration.

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