Comparative study of low-pressure versus standard-pressure pneumoperitoneum in laparoscopic cholecystectomy

Abstract

Background A pressure range of 12–14 mmHg is used in standard-pressure pneumoperitoneum during laparoscopic cholecystectomy. Utilizing low-pressure pneumoperitoneum, which ranges between 7 and 10 mmHg, has become widespread as a way to reduce the effects of pneumoperitoneum on human physiology while still allowing for sufficient working space. Aim This study’s objective is to evaluate the outcome of laparoscopic cholecystectomy with low-pressure pneumoperitoneum against standard-pressure pneumoperitoneum. Patients and methods The study comprised 80 patients who underwent laparoscopic cholecystectomy and for symptomatic gallstone disease. The participants were divided into two groups of 40. During the procedure, 40 patients underwent standard-pressure pneumoperitoneum, while another 40 patients underwent low-pressure pneumoperitoneum. Operative time, intraoperative injuries or mortality, conversion to open surgery, alterations in blood pressure and heart rate during operation, incidence of postoperative shoulder tip pain, need for additional analgesia postoperatively, and incidence of postoperative nausea and vomiting were all recorded as outcome parameters. Results The mean time of operation in patients with low-pressure pneumoperitoneum was 65±10.6 min and with standard-pressure pneumoperitoneum was 61±9.7 min. Neither blood pressure nor heart rate changed in a way that was statistically significant when lower pressure pneumoperitoneum was used. Compared to the standard-pressure laparoscopic cholecystectomy group, the low-pressure group experienced statistically less postoperative shoulder pain (P<0.05). Nothing significantly different was seen in nausea and vomiting between the two groups (P=0.767). Conclusion While reduced intensity postoperative shoulder pain is a benefit of low-pressure pneumoperitoneum for the patient, it has no positive impact on intraoperative hemodynamics, operative time, intraoperative injuries, or mortality.