気腹法腹腔鏡下手術中の肝機能の経時的変動—Finger piece法クリアランスメータを用いたICG K値，Rmax値の検討

Serial Changes in Hepatic Function during Laparoscopic Surgery with Pneumoperitoneum:Determination of ICG K and Rmax Values using a Clearance Meter with Finger Piece Method

　気腹圧12mmHgで施行された腹腔鏡下胆嚢摘出術の9例において，麻酔導入後の気腹前，気腹開始20分後の気腹中，気腹終了後麻酔覚醒前，の3時点のICG K値ならびにRmax値を新しく開発されたfinger piece法クリアランスメータを用いる測定法により観察した．ICG K値，Rmax値とも気腹中は気腹前に比べて低下し，気腹終了後は気腹前と同程度に回復した．腹腔鏡下手術に際しての気腹中は，ICG K値で観察される有効肝血流量の低下のみならず，ICG Rmax値で観察される肝機能の一時的変化が招来されている可能性が示唆された．

ICG K and Rmax values were investigated using clearance meter with finger piece method and newly devel-oped calculation method in 9 patients who underwent laparoscopic cholecystectomy with 12 mmHg pneumoperitoneum. The values were measured at three points during anesthesia : before pneumoperitoneum, 20 min after the completion of pneumoperitoneum, and after depneumoperitoneum. Both ICG K and Rmax val-ues during pneumoperitoneum decreased, as compared to the values before pneumoperitoneum. These values recovered after depneumoperitoneum.