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首页> 外文期刊>Surgical Endoscopy >Fibrinolytic responses of human peritoneal fluid in laparoscopic cholecystectomy: a prospective clinical study.
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Fibrinolytic responses of human peritoneal fluid in laparoscopic cholecystectomy: a prospective clinical study.

机译：腹腔镜胆囊切除术中人腹膜液的纤溶反应：一项前瞻性临床研究。

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BACKGROUND: The reduction in peritoneal fibrinolysis is believed to be the pathogenetic mechanism of adhesion formation. The general conclusion based on previous clinical and experimental studies is that laparoscopic procedures produce less adhesion formation. The association between this beneficial effect of laparoscopic cholecystectomy and peritoneal fibrinolytic changes is not clear. Therefore, the authors aimed to compare the effects of open and laparoscopic cholecystectomy on peritoneal fibrinolysis. For this purpose, fibrinolytic parameters in peritoneal fluid were investigated 24 h after laparoscopic and open cholecystectomies. METHODS: In a prospective clinical study, peritoneal fluid was sampled via a drain 24 h after laparoscopic (n = 10) and open (n = 9) cholecystectomies. Activities and concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1), and tPA/PAI-1 complex were determined by enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: In peritoneal fluids, tPA and tPA/PAI-1 complex concentrations were higher in the open cholecystectomy group (p = 0.009 and p < 0.001, respectively), but tPA activity and PAI-1 concentrations did not differ between the groups (p = 0.514 and p = 0.716, respectively). CONCLUSIONS: Fibrinolytic changes in peritoneal fluid have several similarities in open and laparoscopic cholecystectomies with regard to tPA activity and PAI-1 levels. However, higher tPA levels after the open procedure probably are secondary to more intense tissue handling leading to mesothelial release of tPA.
机译：背景：腹膜纤维蛋白溶解的减少被认为是粘连形成的发病机制。根据先前的临床和实验研究得出的一般结论是，腹腔镜手术产生的粘连较少。腹腔镜胆囊切除术的这种有益效果与腹膜纤维蛋白溶解改变之间的关联尚不清楚。因此，作者旨在比较开放式和腹腔镜胆囊切除术对腹膜纤维蛋白溶解的影响。为了这个目的，在腹腔镜和开腹胆囊切除术后24小时研究腹膜液中的纤溶参数。方法：在一项前瞻性临床研究中，腹腔镜（n = 10）和开腹（n = 9）胆囊切除术后24小时通过引流管抽取腹膜液。通过酶联免疫吸附测定（ELISA）试剂盒测定组织纤溶酶原激活物（tPA），纤溶酶原激活物抑制剂1型（PAI-1）和tPA / PAI-1复合物的活性和浓度。结果：在开腹胆囊切除术组中，腹膜液中的tPA和tPA / PAI-1复合物浓度较高（分别为p = 0.009和p <0.001），但两组之间的tPA活性和PAI-1浓度没有差异（p分别为0.514和p = 0.716）。结论：在tPA活性和PAI-1水平方面，腹腔积液的纤溶变化在开放性和腹腔镜胆囊切除术中有若干相似之处。但是，开放手术后较高的tPA水平可能是继更强烈的组织处理导致tPA间皮释放后继发的。

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