Peritoneal changes due to CO_2 pneumoperitoneum

Objective: To investigate characteristic alterations of the peritoneum after CO2 pneumoperitoneum used in laparoscopic surgery.Methods: Eighty patients with acute cholecystitis were randomly divided into 2 equal groups to undergo laparoscopic surgery with CO2 pneumoperitoneum or laparotomy respectively.Specimens of parietal peritoneum were obtained at appropriate time points to undergo scanning electronmicroscopy to observe the morphological changes.Results: In the laparotomy group,there was no marked change.However,in the CO2 pneumoperitoneum group bulging up of mesothelial cells was evident immediately at the time of filling of CO2,intercellular spaces could be found,and the basement membrane lost its continuity and became uncovered.Conclusion: The morphologic integrity of the peritoneum is temporarily disturbed by a CO2 pneumoperitoneum.