Pulmonary function and complications after laparoscopic cholecystectomy

Abstract

Laparoscopic cholecystectomy causes less impairment of lung function than cholecystectomy through an upper midline incision.

Influence of Preemptive Analgesia on Pulmonary Function and Complications for Laparoscopic Cholecystectomy

“…We used standard hypothermic CO 2 for both groups. Postoperative reduction in FVC, FEV 1 , and FEF 25-75 ranged from 20-40% after LC [18][19][20], and our reduction ratios for both FVC and FEV 1 matched these studies well. Latimer et al [21] showed that a decrease in FEV 1 is secondary to a loss of lung volume rather than a major airway obstruction.…”

Effect of effort pain after upper abdominal surgery on two independent measures of respiratory function

“…Preoperative spirometric and manometric measurements were substantially below predicted normal values (Table 1), presumably because of muscle weakness associated with cancer. These preoperative limitations were greater than in other studies [1,24,[27][28][29]35], although most investigators did not relate their results to a standard, normal population [5,12,14,18,19,26,29]. The effect of differences in personality and motivation should be minimal since each patient served as his or her own control for all measurements; likewise, sedation should have acted similarly for each measurement on a given day.…”

“…Only three efforts were performed for either spirometry, inspiratory, or expiratory pressure, with up to one minute rest between each effort [12]. Subjects were verbally encouraged by the investigator to achieve maximal effort with the best reading chosen for analysis.…”

Difficult Laparoscopic Cholecystectomy: Role of Ultrasonography

“…Laparoscopic cholecystectomy (LC) is now the standard procedure for the treatment of symptomatic gallbladder stones. Although laparoscopic cholecystectomy has numerous advantages including reduced hospitalization, decreased morbidity, short recovery time, and better cosmesis [4][5], it has increased risk of injury to common bile duct (CBD), duodenum, bowel, iliac vessels, high conversion rate in acute cholecystitis and difficulty in management of simultaneous CBD stones. [6][7][8] The results of laparoscopic cholecystectomy are greatly influenced by the skill and experience of the surgeon performing the procedure and reflect acquisition of appropriate technical skills.The conversion of laparoscopic to open cholecystectomy usually reflects sound surgical judgment, and it should be considered as such, rather than a complication of the procedure.Open cholecystectomy remains a safe and effective procedure for the treatment of patients with symptomatic gallstones and is the gold-standard with which all other procedures must be compared.…”