Postoperative pulmonary function in laparoscopic versus open cholecystectomy: prospective, comparative study.
BACKGROUND
Pulmonary complications remain a leading cause of morbidity after major abdominal operations.


OBJECTIVE
To compare pulmonary function and the frequency of pulmonary complications after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).


METHODS
Fifty-five patients with symptomatic gallstone disease undergoing elective cholecystectomy (LC 40, OC 15) under general anesthesia were evaluated using pulmonary function tests (forced vital capacity [FVC], forced expiratory volume at 1 second [FEV1], and forced expiratory flow at 25% to 75% [FEF25% -75%], chest X-ray and pulse oximetry before and after surgery.


RESULTS
FVC, FEV1 and FEF25% -75% decreased by 21.5%, 21.2% and 30.3%, respectively, on postoperative day 1 following LC, and by 44.3%, 46.2% and 58.3%, respectively, after OC. Chest X-ray showed atelectasis in 15% of patients undergoing LC and 45% of those with OC.


CONCLUSIONS
Impairment in pulmonary function after LC was less marked than after OC.
Ravimohan
S M
SM
Department of Surgery, Post-Graduate Institute of Medical Education and Research, Chandigarh-160 012, India.
Kaman
Lileswar
L
Jindal
Ravul
R
Singh
Rajinder
R
Jindal
S K
SK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002764:Cholecystitis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D011183:Postoperative Complications / Q000175:diagnosis*; D011184:Postoperative Period; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012120:Respiration Disorders / Q000175:diagnosis; D012129:Respiratory Function Tests; D018570:Risk Assessment