title: Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic cholecystectomy: a systematic review and meta-analysis.
abstract: BACKGROUND
  The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear.
  
  
  METHODS
  A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed.
  
  
  RESULTS
  A total of 1,263 patients were included. Low-pressure pneumoperitoneum was associated with significantly decreased postoperative pain. The requirement for increased pressure was significantly greater in the low-pressure group (risk ratio = 6.16; P < .001). Operative time was similar, with only a slight statistical significance (weighted mean difference = 2.07; P < .001). Length of hospital stay was shorter in the low-pressure group (weighted mean difference = -.27; P = .01). No significant differences were found in surgical complications or conversion to open surgery.
  
  
  CONCLUSIONS
  Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative pain and near-equal operative time compared with standard-pressure pneumoperitoneum. More studies are required to investigate the potential benefits of the reduced length of hospital stay.
authors: Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China; Department of General Surgery, First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China.
authors: Jie
authors: J
authors: Hua
authors: Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China.
authors: Jian
authors: J
authors: Gong
authors: Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China.
authors: Le
authors: L
authors: Yao
authors: Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China.
authors: Bo
authors: B
authors: Zhou
authors: Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China. Electronic address: zs_song@hotmail.com.
authors: Zhenshun
authors: Z
authors: Song
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D061887:Conversion to Open Surgery; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D015233:Models, Statistical; D061646:Operative Time; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Laparoscopic cholecystectomy; Low-pressure pneumoperitoneum; Meta-analysis; Postoperative shoulder pain; Standard-pressure pneumoperitoneum