Influence of Electric Current on Liver Parenchyma of the Rat

Vokurka J . : Influence of Electric Current on Liver Parenchyma of the Rat. Acta Vet. Brno 2003,72: 547-551. The aim of this study was to investigate the effects of monopolar electrocautery (MPEC) on hepatic parenchyma in rats. Before and after the MPEC application on hepatic parenchyma, blood samples were taken in order to determine the serum bilirubin values. The evaluation of the results has shown that serum bilirubin level changes in consequence of MPEC application on hepatic parenchyma. However, neither association of the degree of this change with current intensity, MPEC duration nor the time of sampling could be proven. The degree of injury to the periphery of the liver necrosis resulting due to MPEC is a function of time. Before the 2nd day after MPEC application, the lesions in the hepatic parenchyma have not been fully developed yet. However, the finding of predominantly focal and multifocal necroses with leucocytic and lymphocytic perifocal reaction, occuring between the 2nd and 10th day even in the remote parts of the hepatic parenchyma outside the wedged necrosis as shown by the histological examination, seems important: it can help explain some elevated hepatic enzyme activities after the monopolar electrocautery. The results for the clinical practice is that after application of MPEC onto hepatic parenchyma may be temporary changes of some hepatic function values. These changes shall not be the reason for restricting the use of MPEC in practice. Monopolar electrocautery, operations In a questionnaire inquiry performed by the author (J. Vokurka) at 70 surgery departments in the Czech Republic, 170 cases of complications have been reported out of a total of 9280 laparoscopic cholecystectomies. From these, 13 cases were complications caused postoperatively by monopolar electrocautery which is widely used in most surgery departments for control of bleeding from small-diameter vessels during laparoscopic interventions (Kala et al. 2000; Olejník et al. 2003). Another interesting finding emerging from the questionnaire inquiry has been an elevation of serum bilirubin values in a non-obstructive manner in patients after undergoing succesful laparoscopic cholecystectomy (·efr et al. 1995). An increase in Bi/S occurring after the intervention was diagnosed in total of 254 patients operated on, i. e. in 2.74% of all cases reported. Interestingly, these have always been patients treated with monopolar electrocautery for hemostasis (Rovn ̆ et al. 2002; VyslouÏi l et al. 2000). On the basis of the clinical data (Messroghl i et al. 1994; ·efr et al. 1995; Kr‰ka 2001) the present author decided to carry out experiments in order to establish the effect of monopolar electrocautery on hepatic parenchyma with the aim of reducing the possibility of surgical complications during laparoscopic cholecystectomy (Hoskovec et al. 2003). Materials and Methods The experimental work was first prepared theoretically by studying data, then the plan of experiment was submitted to the Committee for Ethics of Medical Experiments at Faculty of Medicine, Masaryk University in Brno for approval. The Committee approved the experimental study. A total of 108 operated experimental animals were included in the experiment. The experiment was performed on adult healthy rats under general anaesthesia. The weights of individual rats ranged from 150 g to 550 g with a mean value of 314 g. ACTA VET. BRNO 2003, 72: 547–551 Address for correspondence: Doc. MUDr. Jifií Vokurka, CSc. I. chirurgická klinika, nemocnice u sv. Anny Pekafiská 53, 656 91 Brno Czech Republic Phone: +420 543 182 360 Fax: +420 543 182 373 E-mail: vokurka@med. muni. cz http://www.vfu.cz/acta-vet/actavet.htm