Pneumoperitoneum after laparoscopic cholecystectomy: frequency and duration as seen on upright chest radiographs.
OBJECTIVE
This study aimed to determine the frequency and duration of pneumoperitoneum after laparoscopic cholecystectomy, as detected on upright chest radiographs.


METHODS
Fifty-five patients who underwent laparoscopic cholecystectomy were studied prospectively. Upright posteroanterior chest radiographs were obtained 6 hr after surgery (day 1); additional radiographs were obtained on days 2, 4, 7, and 14, if required, until the pneumoperitoneum resolved. A perpendicular measurement of any pneumoperitoneum detected between the diaphragm and the liver was obtained. The pneumoperitoneum was graded as absent, trace (1-5 mm), mild (6-10 mm), or moderate (10-15 mm).


RESULTS
No evidence of pneumoperitoneum was seen on chest radiographs taken 6 hr after surgery (day 1) in 27 (54%) of the 50 patients who completed the study. Of the remaining 23 patients (46%), all but one showed resolution of the pneumoperitoneum in the first week. Of these 23 patients, 17 showed trace pneumoperitoneum and six showed mild pneumoperitoneum on chest radiographs.


CONCLUSIONS
Despite the use of carbon dioxide gas during laparoscopic cholecystectomy, a significant number of patients have postsurgery pneumoperitoneum that is visible on upright chest radiographs. The pneumoperitoneum resolves in most patients within the first week after surgery.
Millitz
K
K
Department of Diagnostic Radiology, Victoria Hospital Corporation, London, Ontario, Canada.
Moote
D J
DJ
Sparrow
R K
RK
Girotti
M J
MJ
Holliday
R L
RL
McLarty
T D
TD
D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D007327:Insufflation; D008297:Male; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011187:Posture; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors
D002245:Carbon Dioxide