CO2 Abdominal Insufflation Decreases Local and Systemic Inflammatory Response in Experimental Acute Pancreatitis

Abstract

Our data demonstrated that CO2 pneumoperitoneum reduced pancreatic inflammation and attenuated systemic inflammatory response in AP. This article suggests that CO2 pneumoperitoneum plays a critical role on the better outcome in patients undergoing laparoscopic pancreatic surgery.

Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort

“…Previously, laparoscopic surgery for acute peritonitis has been under debate due to theoretical concerns of increased bacteraemia and hypercapnia due to the pneumoperitoneum [11, 12]. However, more recent studies suggest even a protective role of the CO 2 pneumoperitoneum with a reduced systemic inflammatory response, but similar bacterial translocation [13, 14]. …”

Effects of intravenous administration of pentoxifylline in pancreatic ischaemia–reperfusion injury

“…Thus, TNF‐α blockage by pentoxifylline did not prevent lung inflammation, probably because TNF‐α is not the only cytokine responsible for the development of neutrophil infiltration or because its suppression does not affect other activation pathways of the systemic inflammatory response. In a previous study, the present group has also shown that experimental acute pancreatitis causes lung inflammation, and pretreatment with carbon dioxide (CO 2 ) abdominal insufflation attenuated the systemic inflammatory response but did not alter lung MPO activity . By contrast, Kim et al .…”

Role of Peritoneal Macrophages on Local and Systemic Inflammatory Response in Acute Pancreatitis

“…38 The CO 2 pneumoperitoneum also decreases the inflammation in the peritoneal cavity reducing the volume of ascitic fluid and the total content of TNF-. 38 It is conceivable that if an endoscopic procedure for stone retrieval has to be performed it should be done during the laparoscopic cholecystectomy to decrease the inflammatory response secondary to acute pancreatitis. These results suggested that peritoneal macrophages play an important role on the outcome of acute pancreatitis and should be considered an important target for therapeutic management in acute pancreatitis.…”

“…36 Recently, we have demonstrated that CO 2 abdominal insufflation decreases pancreatic inflammation and systemic inflammatory response in an acute pancreatitis model. 38 (Tables 6-8 Table 8. Effect of CO 2 insufflation on the expression of COX-2 and iNOS (Western blot analysis) in the pancreas in acute pancreatitis (AP).…”