Alterations in pulmonary function following laparoscopic cholecystectomy

Malaya Kumar Patel, Sheela Ekka, Mahendra Ekka, Pujarini Beuria, Sapan Kumar Jena

Abstract


Background: In laparoscopic cholecystectomy, inflammation of the punctured abdominal wall or gall bladder bed, carbon dioxide pneumo-peritoneum and intraoperative patient position has significant effect in the pathogenesis of pulmonary dysfunction. The objective of this study is to detect any changes in
pulmonary functions following laparoscopic cholecystectomy using bedside spirometry and to detect degree of impairment of pulmonary function, their complications and the time taken for recovery of postoperative spirometry measurements to the preoperative (baseline) values.
Materials and Methods: This was a prospective observational study in which the preoperative and postoperative spirometry of 70 patients undergoing laparoscopic cholecystectomy under general anaesthesia was compared. Pre-operative spirometry was performed to record the baseline values. Patients
who had normal FVC, FEV1, PEFR values were included in the study. Those who were not able to perform acceptable maneuver were excluded from the study. Pulmonary function testing was done twice following surgery on postoperative day one and on postoperative day three. Adequate pain relief was given to attain a VAS score of less than 40. Spirometry values were compared using paired t-test. P-value of <0.05 was considered statistically significant.
Results: Significant differences were found for the Forced Vital Capacity variable (p=0.001), Forced Expiratory Volume in the first second (p=0.020) and peak expiratory flow rate (p=0.000) between the preand immediate postoperative periods, indicating restrictive ventilator dysfunction.
Conclusion: Light restrictive respiratory disturbances were observed after laparoscopic cholecystectomy, wih rapid recovery of pulmonary function, which may lower postoperative pulmonary morbidity and mortality.

Keywords: Lungphysiology, Pulmonary function tests, Laparoscopic, Cholecystectomy.


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