Comparison of Standard-pressure and Low-pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Nandhagopal, Vijayaraghavan; Sistla, Sarath Chandra; Kundra, Pankaj; Ananthanarayan, Palghat Hariharan; Karthikeyan, Vilvapathy Senguttuvan; Ali, Sheik Manwar; Sasi, Sajith P.; Vikram, Krishnamurthy

doi:10.1097/sle.0b013e3182937980

Cited by 55 publications

(41 citation statements)

References 13 publications

(17 reference statements)

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“…For example, the beneficial effects of low-pressure procedures on liver function were demonstrated in some studies (13)(14)(15). However, some studies showed the side effects of low-pressure and standardpressure pneumoperitoneum in laparoscopic cholecystectomy on different organs are comparable (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Nematihonar¹,

Fahimihanzaei²,

Kamranmanesh³

et al. 2017

Ann Anesth Crit Care

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Background: Low-pressure pneumoperitoneum during laparoscopic surgeries decreases some side effects related to inflate gas into abdominal cavity. The current study aimed at comparing the effects of standard-and low-pressure pneumoperitoneum on shoulder pain, nausea, and vomiting after laparoscopic cholecystectomy. Methods: In a randomized clinical trial, 202 ASA classes I and II patients, candidates for elective laparoscopic cholecystectomy, were randomly divided into the groups of standard-(12 to 14 mmHg) and low-(6 to 7 mmHg) pressure pneumoperitoneum. Postoperative shoulder pain, nausea, and vomiting were assessed between the 2 groups. Results: Post-operative shoulder pain was statistically lower in low-pressure group in comparison with standard-pressure group (P = 0.001). Nausea and vomiting were not statistically different between the 2 groups (P = 0.54). Conclusions: Low-pressure pneumoperitoneum during laparoscopic cholecystectomy was an efficient method to decrease postoperative shoulder pain.

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Section: Discussionmentioning

confidence: 99%

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Nematihonar¹,

Fahimihanzaei²,

Kamranmanesh³

et al. 2017

Ann Anesth Crit Care

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“…Postoperative respiratory complications prolong the length of hospital stay of patients, with a consequent increase in hospital costs and significantly contributing to patient mortality 26 .…”

Section: ■ Discussionmentioning

confidence: 99%

Comparative study of respiratory muscle strength in women undergoing conventional and single-port laparoscopic cholecystectomy

et al. 2017

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Purpose: To evaluate respiratory muscle strength (PImax and PEmax) before and 24 and 48 h after conventional and single-port laparoscopic cholecystectomy. Methods: Forty women with symptomatic cholelithiasis (18 to 70 years) participated in the study. The patients were divided into two groups: 21 patients undergoing conventional laparoscopic cholecystectomy and 19 patients undergoing single-port laparoscopic cholecystectomy. Differences were considered to be significant when p<0.05. Results:The results showed a greater decline in PImax after 24 h in the group submitted to conventional laparoscopic cholecystectomy, with a significant difference between groups (p=0.0308). Conclusion: Recovery of the parameters studied was more satisfactory and respiratory muscle strength was less compromised in the group submitted to single-port laparoscopic cholecystectomy.

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“…Various authors have reported that laparoscopic cholecystectomy performed with LPP results in a better postoperative quality of life as compared to laparoscopic cholecystectomy performed with HPP. [16][17][18] In our study contact of parietal peritoneum to the underlying viscera during secondary port insertion under vision after insertion of primary port, was taken as indirect indicator of potential of causing visceral injury at a particular intraabdominal pressure. Out of 180 secondary ports inserted, there was evident contact of 20 (11.1%) secondary ports in high pressure groups and 14 (7.7%) secondary ports in low pressure group, which is suggestive of adequate exposure and working space available for surgery at both pressures.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative safety of low pressure pneumoperitoneum cholecystectomy: a comparative study

Mahajan¹,

Shankar²,

Garg³

et al. 2017

Int Surg J

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Background: With the establishment of laparoscopic cholecystectomy as gold standard for management of cholelithiasis, the current stress is on increasing patient safety. Hence, this study was undertaken to compare the effect of low pressure pneumoperitoneum (LPP <10mm Hg) versus high pressure pneumoperitoneum (HPP >14mm Hg) in a prospective randomized manner on intraoperative safety, assessing the working space and safety by seeing contact of parietal peritoneum to underlying viscera during secondary port insertion.Methods: 120 patients undergoing laparoscopic cholecystectomy were randomized into the LPP (<10mm Hg) group (n=60) and the HPP (>14mm Hg) group (n=60) prospectively. Available working space assessed directly, safety by contact of parietal peritoneum to underlying viscera during secondary port insertion and operative difficulty assessed by visualization, dissection and grasping, total duration of surgery; intra-operative gas consumption, and bile spillage were assessed.Results: There was no significant difference in terms of available working space, operative duration, consumption of carbon dioxide, surgeon’s operative difficulty and intraoperative bile spillage. Out of 180 secondary ports inserted, there was evident contact of 20 (11.1%) secondary ports in high pressure groups and 14 (7.7%) secondary ports in low pressure group, which is suggestive of adequate exposure and working space available for surgery at both pressures.Conclusions: Low-pressure cholecystectomy did not compromise intraoperative safety and should be the standard of care in day care surgery.

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Comparison of Standard-pressure and Low-pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Abstract: The use of low-pressure pneumoperitoneum (8 mm Hg) for LC is associated with a significantly lower postoperative pain. However, the use of this low-pressure pneumoperitoneum can jeopardize the surgeon's comfort.

Cited by 55 publications

References 13 publications

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

Comparative study of respiratory muscle strength in women undergoing conventional and single-port laparoscopic cholecystectomy

Intraoperative safety of low pressure pneumoperitoneum cholecystectomy: a comparative study

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