Low Pressure versus Standard Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 25, Volume 75, Issue 3, April 2019, Page 2499-2504 PDF (507.11 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2019.31076 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mahmoud Kassem  ; Magdy Mahmoud Emam; Mohammad Arafat Abd El-Maksoud
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| General Surgery Department, Faculty of Medicine, Al-Azhar University | ||||
| Abstract | ||||
| Background: the laparoscopic cholecystectomy (LC), one of the utmost commonly assumed operations in general surgery. Adequate working space inside the abdominal cavity is required. Carbon dioxide (CO2) is used with a definite pressure to establish this working space. Aim: our study was to compare the hemodynamic symptoms, post-operative shoulder-tip pain and the frequency of nausea and vomiting between standard and low-pressure CO2 pneumoperitoneum (PP) in patients undergoing LC. Patients and Methods: a prospective randomized study was done on 50 patients aged 18 to 75 years in Bab ElShaaria hospital, Al-Azhar University with symptomatic gallstones. Patients were allocated into two groups: standard pressure (Group A: 12-14 mmHg) and low-pressure (Group B: 8-10 mmHg). Hemodynamics were assessed pre insufflation and 15 min post insufflation and desufflation. The frequency of nausea and vomiting were assessed at 0, 8, 16, 24-hour post-operative. Post-operative shoulder- tip was assessed 1, 6, 12, 24-hour post-operative. Statistical analysis was postulated using SPSS V.25. Results: a noticeable difference between the two groups was observed with respect to the mean systolic blood pressure (p=0.003) and the mean heart rate (p=0.001). Furthermore, a significant difference as regard post-operative shouldertip pain, which was higher in the standard pressure group (p< 0.05). There were no major differences between the two groups concerning the frequency of nausea and vomiting. Conclusion: low-pressure PP can be used instead of standard pressure considering its low side effects without any effect on the working space and quality of the surgical procedure. | ||||
| Keywords | ||||
| cholethiasis; Laparoscopic cholecystectomy; low-pressure; pneumoperitoneum | ||||
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