Open Versus Laparoscopie Cholecystectomy A Comparison of Postoperative Pulmonary Function

TLDR

Upper‑abdominal surgery induces pulmonary function changes that raise the risk of lower‑lobe atelectasis. The study aimed to determine whether laparoscopic cholecystectomy reduces postoperative pulmonary risk compared to the open approach. Sixteen open and twenty laparoscopic patients underwent pre‑ and postoperative pulmonary function tests (FVC, FEV‑1, FEF 25‑75%) and postoperative values were expressed as a percentage of baseline. Post‑operative pulmonary function was significantly better after laparoscopic surgery (FVC 73 % vs 52 %, FEV‑1 72 % vs 53 %, FEF 81 % vs 53 %) indicating that laparoscopy improves pulmonary outcomes (p = 0.002–0.006).

Abstract

Upper abdominal surgery is associated with characteristic changes in pulmonary function which increase the risk of lower lobe atelectasis. Sixteen patients undergoing open cholecystectomy and 20 patients undergoing laparoscopie cholecystectomy were prospectively evaluated by pulmonary function tests (forced vital capacity [FVC], forced expiratory volume [FEV-1], and forced expiratory flow [FEF] 25% to 75%) before operation and on the morning after surgery to determine if the laparoscopie technique lessens the pulmonary risk. Fraction of the baseline pulmonary function was calculated by dividing the postoperative pulmonary function by the preoperative pulmonary function and multiplying by 100%. Postoperative FVC measured 52% of preoperative function for open cholecystectomy and 73% for laparoscopie cholecystectomy (p = 0.002). Postoperative FEV-1 measured 53% of baseline function for open cholecystectomy and 72% for laparoscopie cholecystectomy (p = 0.006). Postoperative FEF 25% to 75% measured 53% for open cholecystectomy and 81% for laparoscopie cholecystectomy (p = 0.07). It is concluded that laparoscopie cholecystectomy offers improved pulmonary function compared to the open technique.