{'fraction_non_alphanumeric': 0.02776572668112798, 'fraction_numerical': 0.013015184381778741, 'mean_word_length': 5.335164835164835, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Effects of Different Intraabdominal Pressures on Internal Jugular Vein, Liver and Kidney Functions in Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy.

OBJECTIVE
The aim of this study was to investigate whether there was a difference in laparoscopic sleeve gastrectomy (LSG) performed with either 10 mmHg or 13 mmHg intraabdominal pressures. Effects ​​of these pressures on the internal jugular vein (IJV) diameter and flow along with the liver and kidney function tests were evaluated.


MATERIALS AND METHODS
The patients were divided into two groups with respect to the intraabdominal pressure performed during LSG (either 10 mmHg or 13 mmHg). The patients' age, comorbidities, surgical history, height, weight, body mass index, family history, duration of surgery, length of hospital stay,serum liver and kidney function tests (Urea, creatinine, Aspartate transaminase, Alanine transaminase, Gamma-glutamyltransferase, Alkaline phosphatase, bilirubin) and the right IJV diameter and flow measured by Duplex ultrasound before intubation (t1), 10 minutes after insufflation (t2), and at the end of insufflation (t3) were recorded.


RESULTS
Preoperative and postoperative kidney and liver function values ​​of the patients in both groups were within the reference range. In both groups, there was a significant decrease in the IJV diameter and flow measurement values ​​at t2 compared to t1, and a significant increase was observed at t3 compared to t2 (p < 0.05). The mean IJV diameter and flow were significantly higher in the 10 mmHg pressure group compared to the 13 mmHg group (p < 0.05).


CONCLUSION
Neither of the peak pressures performed intraabdominally during LSG caused an adverse effect on liver or kidney functions. Our study emphasizes that low insufflation pressure does not have an advantage in terms of liver and kidney functions. But laparoscopic sleeve gastrectomy with low intra-abdominal pressure may be beneficial especially in patients who require central vein catheterization during the operation.We consider that LSG performed with CO2 pneumoperitoneum at 10 mmHg is a safe, effective and feasible method that can facilitate the insertion of intraoperative central venous catheter due to lesser changes in the IJV diameter and flow compared to the standard technique.