Surgical Endoscopy And Other Interventional Techniques

, Volume 16, Issue 9, pp 1292–1296 | Cite as

Impact of dopamine and endothelin-1 antagonism on portal venous blood flow during laparoscopic surgery

  • Z. G. Kim
  • E. Sanli
  • L. Brinkmann
  • M. Lorenz
  • C. N. Gutt
Original Articles



Recent data indicate that pneumoperitoneal carbondioxide (CO2) insufflation impairs hepatic macro- and microcirculation. Whether dopamine and endothelin-1 (ET-1) antagonists might restore liver blood during laparoscopic surgery has not yet been investigated.


For this study, 30 male WAG/Rij rats were randomized into two groups to obtain pneumoperitoneum with CO2 (n=15) or helium (n=15). All the animals were implanted with a polyethylene-50 cannula into the right vena jugularis and a Doppler ultrasound flow probe around the portal vein. In each group, the rats were administered dopamine (n=5); JKC-10, JKC-301, which is a selective endothelin-1 (ET-1) antagonist (n=5), or sodium chloride as a control (n=5). Portal blood flow was measured during intraabdominal pressures 2 to 12 mmHg. Data were analyzed using the Kruskal-Wallis h-test.


The application of dopamine and ET-1 antagonists significantly improved portal blood flow over that of the control animals (p<0.05). No significant differences were found between CO2 and helium insufflation (p>0.05).


Dopamine and ET-1 antagonism restore portal blood flow during laparoscopic surgery independantly of the insufflation gas. Whether improved hepatic perfusion might have beneficial effects on liver function needs further investigation.

Key words

Laparoscopy Pneumoperitoneum Portal blood flow Dopamine Endothelin antagonism 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Andersen MN, Kuchiba K (1970) Measurement of acute changes in liver function and blood flow. Arch Surg 100: 541–545PubMedGoogle Scholar
  2. 2.
    Baratz RA, Karis JH (1969) Blood gas studies during laparoscopy under general anesthesia. Anesthesiology 30: 463–464PubMedGoogle Scholar
  3. 3.
    Barnes GE, Laine GA, Giam PY, Smith EE, Granger HJ (1985) Cardiovascular responses to elevation of intraabdominal hydrostatic pressure. Am J Physiol 248: 208–213Google Scholar
  4. 4.
    Bauer M, Zhang JX, Bauer I, Clemens MG (1994) ET-1-induced alterations of hepatic microcirculation: sinusoidal and extrasinusoidal sites of action. Am J Physiol 267: G143-G149PubMedGoogle Scholar
  5. 5.
    Benigni A, Remuzzi G (1999) Endothelin antagonists. Lancet 353: 133–138PubMedCrossRefGoogle Scholar
  6. 6.
    Cisek LJ, Gobet RM, Peters CA (1998) Pneumoperitoneum produces reversible renal dysfunction in animals with normal and chronically reduced renal function. J Endourol 12: 95–100PubMedCrossRefGoogle Scholar
  7. 7.
    Drougas JG, Barnard SE, Wright JK, Sika M, Lopez RR, Stokes KA, Williams PE, Pinson CW (1996) A model for extended studies of hepatic hemodynamics and metabolism in swine. Lab Anim Sci 46: 648PubMedGoogle Scholar
  8. 8.
    Eleftheriadis E, Kotzampassi K, Botsios D, Tzartinoglou E, Farmakis H, Dadoukis J (1996) Splanchnic ischemia during laparoscopic cholecystectomy. Surg Endosc 10: 324–326PubMedCrossRefGoogle Scholar
  9. 9.
    Gandhi CR, Stephenson K, Olson MS (1996) Endothelin, a potent peptide agonist in the liver. J Biol Chem 265: 17432–17435Google Scholar
  10. 10.
    Giullian JA, Marsh JW, Chung OK, Drougas JG, Wright JK, Chapman WC, Blair KT, Barnard SE, Feurer ID, Pinson CW (1999) Effects of dopamine infosion (3–30 μg/kg/min) on hepatic hemodynamics. J Surg Res 88: 52–57CrossRefGoogle Scholar
  11. 11.
    Goeting NL, Fleming JS, Gallagher P, Walmsely BH, Karran SJ (1986) Alterations in liver blood flow and reticuloendothelial function in progressive cirrhosis in the rat. J Nucl Med 27: 1751–1754PubMedGoogle Scholar
  12. 12.
    Gutt CN, Heinz P, Kaps W, Paolucci V (1997) The phagocytosis activity during conventional and laparoscopic operations in the rat: a preliminary study. Surg Endosc 11: 899–901PubMedCrossRefGoogle Scholar
  13. 13.
    Gutt CN, Kim ZG, Schmandra T, Paolucci V, Lorenz M (2000) Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model. Surgery 127: 566–570PubMedCrossRefGoogle Scholar
  14. 14.
    Gutt CN, Riemer V, Brier C, Berguer R, Paolucci V (1998) Standardized technique of laparoscopic surgery in the rat. Dig Surg 15: 135–139PubMedCrossRefGoogle Scholar
  15. 15.
    Gutt CN, Riemer V, Kim ZG, Erceg J, Lorenz M (2001) Impact of laparoscopic surgery on experimental hepatic metastases. Br J Surg 88: 371–375PubMedCrossRefGoogle Scholar
  16. 16.
    Gutt CN, Schmandra TC (1999) Portal venous flow during CO2 pneumoperitoneum in the rat. Surg Endosc 13: 902–905PubMedCrossRefGoogle Scholar
  17. 17.
    Hamilton BD, Chow GK, Inman SR, Stowe NT, Winfield HN (1998) Increased intraabdominal pressure during pneumoperitoneum stimulates endothelin release in a canine model. J Endourol 12: 193–197PubMedCrossRefGoogle Scholar
  18. 18.
    Harris MN, Platevin OM, Crowther A (1984) Cardiac arrhythmias during anaesthesia for laparoscopy. Brit J Anaesth 56: 1213–1217PubMedCrossRefGoogle Scholar
  19. 19.
    Hashikura Y, Kawaski S, Munakata Y, Hashimoto S, Hayashi K, Makuuchi M (1994) Effects of peritoneal insufflation on hepatic and renal blood flow. Surg Endosc 8: 759–761PubMedCrossRefGoogle Scholar
  20. 20.
    Ivankovich AD, Miletich DJ, Albrecht MD, Heymann HJ, Bonnet RF (1975) Cardiovascular effects of intraperitoneal insufflation with carbon dioxide and nitrous oxide in digs. Anaesthesiology 42: 281CrossRefGoogle Scholar
  21. 21.
    Jakimowicz J, Stultiens G, Smulders F (1998) Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc 12: 129–132PubMedCrossRefGoogle Scholar
  22. 22.
    Kamath PS, Tyce GM, Miller VM, Edwards BS, Rorie DK (1999) Endothelin-1 modulates intrahepatic resistance in a rat model of noncirrhotic portal hypertension. Hepatology 30: 401–407PubMedCrossRefGoogle Scholar
  23. 23.
    Kelman GR, Swapp GH, Smith I, Benzie RJ, Gordon NLM (1972) Cardiac output and arterial blood gas tension during laparoscopy. Br J Anaesth 44: 1155–1162PubMedCrossRefGoogle Scholar
  24. 24.
    Kinoshita G, Washizu M, Murata N, Kondo M, Matsukura Y, Washizu T, Motoyoshi S (1996) The selective effect of dopamine and dobutamine on liver circulation in the dog. J Vet Med Sci 57: 293Google Scholar
  25. 25.
    Kojima H, Yamao J, Tsujimoto T, Uemura M, Takaya A, Fukui H (2000) Mixed endothelin receptor antagonist, SB209670, decreases portal pressure in biliary cirrhotic rats in vivo by reducing portal venous system resistance. J Hepatol 32: 43–50PubMedCrossRefGoogle Scholar
  26. 26.
    Morino M, Giraudo G, Festa V (1998) Alterations in hepatic function during laparoscopic surgery: an experimental clinical study. Surg Endosc 12: 968–972PubMedCrossRefGoogle Scholar
  27. 27.
    Nishihara K, Sakata K, Yagyu T, Nakashima K, Suzuki T (1994) Relationship between peripheral portal blood flow and liver function in patients with liver cirrhosis: pulsed Doppler ultrasonographic study. Scand J Gastroenterol 29: 859–864PubMedCrossRefGoogle Scholar
  28. 28.
    Okumura S, Takei Y, Kawano S, Nagano K, Masuda E, Goto M, Tsuji S, Michida T, Chen SS, Kashiwagi T, Fusamoto H, Kamada T, Sato N (1994) Vasoactive effect of endothelin-1 on rat liver in vivo. Hepatology 19: 155–161PubMedGoogle Scholar
  29. 29.
    Oldner A, Wanecek M, Goiny M, Weitzberg E, Rudehill A, Alving K, Sollevi A (1998) The endothelin receptor antagonist bosentan restores gut oxygen delivery and reverses intestinal mucosal acidosis in porcine endotoxin shock. Gut 42: 696–702PubMedCrossRefGoogle Scholar
  30. 30.
    Peschl L (1978) Klinische und experimentelle Untersuchungen über die Wirkung von Dopamin auf die Hämodynamik und Funktion von Niere und Leber. Wien klein Wochenschr 1978:Suppl 86: 1–33Google Scholar
  31. 31.
    Priebe HJ, Nöldge GFE, Armbruster K, Geiger K (1995) Differential effects of dobutamine, dopamine, and noradrenalin on splanchnic haemodynamics and oxygenation in pigs. Acta Anaesthesiol Scand 39: 1088–1096PubMedCrossRefGoogle Scholar
  32. 32.
    Rasmussen IB, Berggren U, Arvidsson D, Ljungdahl M, Haglund U (1995) Effects of pneumoperitoneum on splanchnic hemodynamics: an experimental study in pigs. Eur J Surg 161: 819–826PubMedGoogle Scholar
  33. 33.
    Schäfer M, Sägesser H, Krähenbühl I (2000) Liver and splanchnic hemodynamic changes in rats during laparoscopy. Surg Endosc to 14 (Suppl 1): S216Google Scholar
  34. 34.
    Schilling MK, Redaelli C, Krähenbühl L, Signer C, Büchler MW (1997) Splanchnic microcirculatory changes during CO2 laparoscopy. J Am Coll Surg 184: 378–382PubMedGoogle Scholar
  35. 35.
    Shuto K, Kitano S, Yoshida T, Bandoh T, Mitarai Y, Kobayashi M (1995) Hemodynamic and arterial blood gas changes during carbon dioxide and helium pneumoperitoneum in pigs. Surg Endosc 9: 1173–1178PubMedCrossRefGoogle Scholar
  36. 36.
    Sogni P, Moreau R, Gomola A, Gadano A, Cailmail S, Calmus Y, Clozel M, Lebrec D (1998) Beneficial hemodynamic effects of bosentan, a mixed ETA and ETB receptor antagonist, in portal hypertensive rats. Hepatology 28: 655–659PubMedCrossRefGoogle Scholar
  37. 37.
    Takagi S (1998) Hepatic and portal vein blood flow during carbon dioxide pneumoperitoneum for laparoscopic hepatectomy. Surg Endosc 12: 427–431PubMedCrossRefGoogle Scholar
  38. 38.
    Tunon MJ, Gonzalez P, Jorquera F, Llorente A, Gonzalo-Orden M, Gonzalez-Gallego J (1999) Liver blood flow changes during laparoscopic surgery in pigs: a study of hepatic indocyanine green removal. Surg Endosc 13: 668–672PubMedCrossRefGoogle Scholar
  39. 39.
    Wang HG, Shibamoto T, Miyahara T (1997) Endothelin-1 selectively contracts portal vein through both ETA and ETB receptors in isolated rabbit livers. Am J Physiol 273: G1036-G1043PubMedGoogle Scholar
  40. 40.
    Winsö O, Biber B, Fornander J, Gustavsson B, Holm C, Häggendal J, Milsom I (1998) Effects of dopamine on portal circulation after therapeutic hepatic artery ligation. Acta Anaesthesiol Scand 32: 458–463CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Z. G. Kim
    • 1
  • E. Sanli
    • 1
  • L. Brinkmann
    • 1
  • M. Lorenz
    • 1
  • C. N. Gutt
    • 1
  1. 1.Department of General and Vascular SurgeryJohann Wolfgang Goethe UniversityFrankfurt/MainGermany

Personalised recommendations